X-ray pre-op PLANNER.

Open a radiograph and plan on it — draw reduction vectors, trace fragments, and drop in real screws, plates, nails, K-wires and clamps. The same planning canvas that is in the OrthoVaultOS app, free and with no account.

There is no upload. The file is opened, drawn on, and flattened entirely on your own machine, and the finished PNG is saved straight to your downloads. Even so: crop out any patient name, MRN or date burned into the corner of the image before you use it, and follow your institution’s rules on handling radiographs. DICOM files are not accepted — their headers carry patient details — so export a PNG or JPG from your viewer first.

What preoperative planning on a radiograph means

Planning a case on the film means deciding, before you scrub, what you are going to do and what you expect to use. For a fracture that is the reduction: which fragment moves, in which direction, and what holds it once it is there. For arthroplasty it is templating: which implant, which size, and where the cut lands. Either way the output is the same — a drawing, and a short list of what you predicted.

The value is not that the plan turns out to be right. Often it will not be. The value is that you had an opinion before the case, so the difference between what you predicted and what actually went in is visible to you afterwards. That gap is the feedback, and without a written plan there is nothing to compare against. There is a longer version of that argument in preoperative templating for hip arthroplasty.

How to draw a reduction vector

A reduction vector is the direction a fragment has to travel to end up where you want it. Drawing it is a three-step habit:

• Trace the fragments first. Outline the main pieces as they lie now. Tracing forces you to decide which cortical line belongs to which fragment, which is the part people skip and then get wrong in theatre.
• Move one piece, not the whole picture. Pick the fragment that is displaced and draw the arrow from where it is to where it should sit against the fragment you are treating as fixed.
• Then ask what holds it. The vector tells you the direction of your reduction force and therefore where the clamp goes and from which side the implant has to come. If the arrow and the plate are on the same side, one of them is wrong.

Choosing plate, screw and nail sizes off a radiograph

The implants in the planner are drawn to scale relative to each other, so you can lay a plate along the bone and see whether the working length you wanted is plausible, how many screws fit either side of the fracture, and whether a nail of that diameter clears the canal.

What you cannot do here is measure in millimetres. Two-dimensional planning depends on knowing the magnification of the film, and magnification depends on a marker of known size in the field. This tool has no calibration step, so treat every size you place as a relative estimate — right shape, right rough proportion, not a measured number. If you need a real measurement, use the templating software your department already has.

What this tool does not do

It is a sketching surface for your own preparation, and it is deliberately narrow:

• No DICOM. It opens ordinary image files — a PNG or JPEG screenshot or photograph of a film. It does not read PACS studies.
• No calibration. There is no magnification marker and no true-size measurement, for the reason above.
• Not a medical device. It is a teaching and preparation aid, not a diagnostic or clinical planning system, and nothing it produces should be used to make a treatment decision on its own.
• Not a place for patient data. Crop out names, medical record numbers and dates of birth before you open a film here — the same rule that applies to any image you keep for your own learning.

Common questions

Is this X-ray planner free?

Yes, and there is no account and no sign-up. It runs in your browser and there is nothing to install.

Is my radiograph uploaded anywhere?

No. The file is opened, drawn on and flattened entirely inside your own browser. It is never sent to a server, so nobody — including us — can see it.

What image formats can I open?

Ordinary image files: PNG and JPEG. A screenshot of a film from your workstation, or a photograph of one, both work. DICOM studies are not supported.

Can I measure real distances or angles in millimetres?

Not accurately. There is no calibration marker, so sizes are relative rather than measured. Use your department's templating software when a real measurement matters.

Is this a medical device?

No. It is a preparation and teaching aid for your own use, not a diagnostic or clinical planning system, and it is not a substitute for clinical judgement.

Can I save or print the plan?

Yes — the finished drawing is flattened onto the image and saved from your browser, so you can keep it with your notes on that case. In the OrthoVaultOS app the same canvas saves the plan against the procedure itself, next to the steps and the surgeon's preferences.