Assessment of In-House Haptic Technology for Virtual Reconstruction in Complex Mandibular Fractures

Overview

This study evaluates the accuracy and precision of the Haptic Assisted Surgical Planning (HASP) system for virtual reduction of complex mandibular fractures using retrospective cases and a plastic skull model. HASP demonstrated intuitive 3D manipulation with haptic feedback, enabling surgeons to perform virtual fracture reductions with measurable accuracy and reproducibility.

Background

Mandibular fractures are common facial injuries often resulting from trauma such as traffic accidents or assaults. Treatment decisions depend on fracture location, stability, displacement, and occlusion impact. Complex fractures with multiple segments pose challenges in restoring the 3D anatomy. Virtual surgical planning (VSP) has improved outcomes in cranio-maxillofacial surgery but commercial systems often require engineers and rely on 2D interfaces, limiting surgeon usability. Haptic technology offers tactile feedback to enhance 3D interaction and may simplify preoperative planning.

Data Highlights

Key Findings

• HASP provides 6 degrees-of-freedom input and 3 degrees-of-force feedback, enabling intuitive manipulation of bone fragments in 3D.
• Virtual reductions performed by three observers showed consistent reproducibility and measurable accuracy compared to the intact mandible model.
• Haptic feedback allowed detection of bone fragment fit and occlusion correctness, reducing interpenetration errors not easily seen visually.
• Segmentation using BoneSplit was efficient, enabling quick separation of bone fragments for import into HASP.
• Virtual planning times were recorded, demonstrating feasibility of the workflow for trauma cases.
• Physical assembly of the fractured plastic mandible revealed that virtual reductions tended to be narrower than the intact anatomy, highlighting areas for system refinement.

Clinical Implications

The HASP system offers surgeons an in-house, surgeon-driven virtual planning tool that integrates tactile feedback to improve 3D fracture reduction accuracy and efficiency. This may reduce reliance on external engineers and shorten planning times in trauma settings. Incorporating haptics can enhance surgeon confidence in fragment positioning and occlusion assessment, potentially improving surgical outcomes in complex mandibular fractures.

Conclusion

HASP demonstrates promising accuracy and precision for virtual reduction of complex mandibular fractures, providing an intuitive haptic interface that may streamline preoperative planning. Further refinement and clinical validation could establish HASP as a valuable tool in cranio-maxillofacial trauma surgery.

References

1. Olsson et al. 2019 -- Haptic Assisted Surgical Planning (HASP) for Mandible Fractures
2. BoneSplit Segmentation Tool Reference