A Time Saver: Optimization Approach for the Fully Automatic 3D Planning of Forearm Osteotomies

Three-dimensional (3D) computer-assisted preoperative planning has become the state-of-the-art for surgical treatment of complex forearm bone malunions. Despite benefits of these approaches, surgeon time and effort to generate a 3D-preoperative planning remains too high, and limits their clinical application. This motivates the development of computer algorithms able to expedite the process. We propose a staged multi-objective optimization method based on a genetic algorithm with tailored fitness functions, capable to generate a 3D-preoperative plan in a fully automatic fashion. A clinical validation was performed upon 14 cases of distal radius osteotomy. Solutions generated by our algorithm (OA) were compared to those created by surgeons using dedicated planning software (Gold Standard; GS), demonstrating that in 53% of the tested cases, OA solutions were better than or equal to GS solutions, successfully reducing surgeon’s interaction time. Additionally, a quantitative evaluation based on 4 different error measurement confirmed the validity of our method.