New technologies for the classifcation of proximal humeral fractures: Comparison between Virtual Reality and 3D printed models—a randomised controlled trial

Abstract

Correct classifcation of fractures according to their patterns is critical for developing a treatment plan in orthopaedic surgery. Unfortunately, for proximal humeral fractures (PHF), methods for proper classifcation have remained a jigsaw puzzle that has not yet been fully solved despite numerous proposed classifcations and diagnostic methods. Recently, many studies have suggested that three-dimensional printed models (3DPM) can improve the interobserver agreement on PHF classifcations. Moreover, Virtual Reality (VR) has not been properly studied for classifcation of shoulder injuries. The current study investigates the PHF classifcation accuracy relative to an expert committee when using either 3DPM or equivalent models displayed in VR among 36 orthopaedic surgery residents from diferent hospitals. We designed a multicentric randomised controlled trial in which we created two groups: a group exposed to a total of 34 3DPM and another exposed to VR equivalents. Association between classifcation accuracy and group assignment (VR/3DPM) was assessed using mixed efects logistic regression models. The results showed VR can be considered a non-inferior technology for classifying PHF when compared to 3DPM. Moreover, VR may be preferable when considering possible time and resource savings along with potential uses of VR for presurgical planning in orthopaedics.