Bone defect post-resection of non-ossifying fibroma of the distal tibia. 3D planning method for calculating the iliac crest graft size.

The management of two surgical sites during the same operation in a pediatric patient raised the need to calculate the size of the graft to be harvested before surgery.

This way, two simultaneous surgical teams made it possible to substantially reduce the operative time by almost halving it. Knowing in advance the size of the defect and the location of the appropriate crest segment and its dimensions, the grafting team is not obliged to wait for the bone defect team to obtain the graft measurements they need.

In our particular case, the crest team harvested the graft within 20 minutes, closing the surgical wound when the direct measurements of the tibial bone defect were not yet known. In virtual planning, we calculated the measurements previously. The extensive iconography available on the computers in the operating room made it possible to reduce the intraoperative fluoroscopy time to only 2 final control images.

Bone models were printed to enhance the visual and haptic experience of the operators.

CT segmentation allows volumetric calculation of the defect. This is especially important in cases where, instead of a structural bone graft, a malleable bone substitute, that is available in volumetric sizes, is to be used. 

We used a geometric graft resecting the defect with the precalculated measurements.

The final result