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Fracture planning

There isn’t a dedicated “fracture mode” — fracture planning combines tools you already use: measurement, reposition, and templates. This article walks through how they fit together.

Before you start

• Calibrate the radiograph (see Calibrating radiographs).
• Open both AP and ML views side-by-side if you have them. They’re separate radiographs in the same case and can both be displayed at once.

Workflow

1. Assess the fracture

Use Measurement to record:

• Fragment lengths
• Bone diameter at intact regions (helps with plate selection)
• Any displacement or overlap

Measurements stay on the radiograph for reference and are visible to anyone you share the case with.

2. Plan the reduction

Switch to Reposition. This lets you virtually move fragments back toward anatomical alignment.

• Outline the fragment first. Edge — click along its edge and the line snaps to it — is the tool for a fracture fragment; Freehand suits a poorly exposed film. Segment is for whole bones only. See Osteotomy and repositioning tools.
• Drag the fragment to translate it, and its rotation stalk to rotate it.
• Multiple fragments can be repositioned independently.

The reposition tool is a planning aid. Actual reduction depends on the soft-tissue envelope, vascular anatomy, and intraoperative findings that aren’t visible on a planning radiograph — don’t over-trust the virtual alignment.

3. Select and place a plate

From the Implants tab, browse for the plate system you intend to use. Filter by screw diameter to narrow the list to the plates that suit the bone in front of you.

Factors worth considering when choosing:

• Working length above and below the fracture (intact bone for screw purchase)
• Plate thickness relative to bone diameter
• Screw count and spacing
• Plate contour relative to the bone surface

The sister-variant swap lets you compare different hole counts and sizes after initial placement without re-aiming.

4. Plan screw positions

The placed plate’s overlay shows screw hole locations. Verify they avoid:

• The fracture line itself
• Intra-articular space
• Major vascular structures

The overlay is geometric — it shows where screws would land but doesn’t know about anatomy. Always cross-reference against the patient’s specific imaging.

5. Save and share

Cases auto-save. Share with your surgical team via referral link if needed. See Sharing and referrals.

What the app does and doesn’t do

• It does show implant footprints accurately, measure distances precisely, and let you experiment with multiple sizes before committing to one.
• It doesn’t assess fracture stability, predict healing, optimise screw trajectories in 3D, or substitute for surgical experience.

Tips for planning a fracture

• For complex fractures, place the plate on the AP view first, then place it on the ML film too — or copy it across (select it, Ctrl/Cmd + C, click the ML film, Ctrl/Cmd + V) — and check it sits correctly there. A plate belongs to the film it was placed on; it does not appear on the other view by itself.
• Use the ruler button in the top bar to hide the readings when reviewing implant placement.
• If you’re considering multiple plates, place all of them and use the eye beside each plate in the Items list to show one at a time. To make room on screen, hide a whole view with Hide this view on that film’s bar (under ⋯ More image tools on a narrow pane), and bring it back from Add View in the header.