Virtual reality as classification aid for acetabular fractures

BACKGROUND: The incidence of acetabular fractures has increased, and classification according to Judet and Letournel remains challenging. While 3D CT improves accuracy, virtual reality (VR) may enhance training. This study assessed whether a VR simulator improves classification accuracy and understanding in inexperienced users. MATERIALS AND METHODS: An HTC VIVE Pro headset and an Alienware m15 R4 computer were utilized. Programming was done in Unity (2021.3.4f1 LTS), and segmentation in Slicer3D. In total, 83 ninth-semester medical students, divided into a VR group (n = 44) and a 3D control group (n = 39), took part. Participants had to classify 11 acetabular fractures, supported by pictograms if needed, followed by a user survey. Accuracy was compared. RESULTS: All participants completed the study. Overall, 68% had no prior knowledge of the classification. The control group achieved a median of 27% (interquartile range [IQR]: 14-36%) correct classifications, while the VR group reached 45% (IQR: 36-64%), showing higher accuracy (p < 0.001). In general, essential fractures were classified significantly more accurately than associated fractures (p < 0.001). The VR system was rated as more intuitive than the 3D software (p = 0.025). CONCLUSION: The VR simulator significantly improved acetabular fracture classification among inexperienced users. It is intuitive, easy to use, and offers strong potential for future surgical training.