• Sander J C Tabernée Heijtmeijer, Anne M L Meesters, Nico J J Verdonschot, Paul C Jutte, Job N Doornberg, Peter A J Pijpker, and Joep Kraeima.
• 3D-Lab, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. s.j.c.tabernee.heijtmeijer@umcg.nl.
• Eur J Trauma Emerg Surg. 2025 Jan 24; 51 (1): 8181.

PurposeCurrently, no gold standard exists for 3D analysis of virtually planned surgery accuracy postoperatively. The aim of this study was to present a new, validated and standardised methodology for 3D postoperative assessment of surgical accuracy in patients undergoing 3D virtually planned and guided corrective osteotomies.MethodsAll patients who underwent 3D planned corrective osteotomy in 2021-2022 at our center with a postoperative CT were included. Postoperative surgical outcome was analysed with a postoperative CT and compared to the preoperative virtual surgical planning to determine achieved accuracy. Validation of the analysis was performed by evaluating the individual assessment of six experienced observers. A postoperative quantification was performed according to the proposed innovative methodology based on rotation axes of a virtual postoperative bone model aligned to the virtual preoperative bone model and virtual surgical planned bone model. To evaluate the intra-observer variability, one observer performed the assessment twice.ResultsQuantification of 13 patients according resulted in measurements with a median range (and its interquartile range) for 3D translation of: 2.43 mm (3.17), for the angle deviations: 3D rotation, 2D coronal, 2D sagittal and 2D axial were: 0.66° (1.66°), 0.74° (0.44°), 0.99° (1.27°), 2.37° (5.00°), respectively. The inter- and intraobserver reliability established with the Intraclass correlation coefficient was for all measurements excellent (> 0.76).ConclusionThe proposed 3D CT technique provides an significant more accurate and objective method for assessment of surgical outcome of a guided corrective osteotomy. The present proposed novel methodology showed excellent inter- and intra-observer reliability with clinically acceptable absolute surgical outcome measurements.© 2025. The Author(s).

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