Innovative imaging-based pre-operative planning for correction of proximal femur malunion with implants in-situ using and PowerPoint.

Background: Proximal femoral malunions with implants in-situ pose a significant challenge for pre-operative planning due to the obstruction of key anatomical landmarks. Existing planning software, while advanced, is often limited by cost, accessibility and a lack of functionality for digital implant removal. The main objective is to introduce a novel, low-cost and accessible two-step digital method for planning deformity correction using Picsart and Microsoft PowerPoint.

Methods: This technique employs , a free photo-editing application, for digital implant removal, followed by Microsoft PowerPoint for deformity measurement and surgical simulation. It allows for angular and rotational assessment, identification of the Centre of Rotation and Angulation (CORA) and planning of corrective osteotomies, external fixation or arthroplasty.

Results: The method supports accurate calibration using antero-posterior and lateral radiographic views and also enables simulation for correction. It is adapted from the Planning for Limb Reconstruction using Slide Presentation Software (PLIRSP) methodology.

Conclusion: This two-step digital approach offers a reproducible and practical alternative for orthopaedic deformity planning. It empowers surgeons and trainees, especially in resource-constrained environments, by enhancing pre-operative precision and encouraging innovation in orthopaedic education and surgical strategy.