Kendoff Daniel, Citak Musa, Gardner Michael J, Stübig Timo, Krettek Christian, Hüfner Tobias
Trauma Department, Hannover Medical School, Carl-Neubergstr. 1, 30655 Hannover, Germany, and Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA.
J Orthop Res. 2007 Jul;25(7):951-7. doi: 10.1002/jor.20383.
Drilling procedures are common in orthopedic surgery and are one specific task that may be aided by computer-assisted navigation. However, the inherent flexibility of drill bit bending may make this the limiting factor in achieving acceptable accuracy when using these systems. We designed an alignment device that was fit to a standard orthopedic drill that allowed an extension of the stabilizing point of a drill bit. In foam blocks with a similar density as cancellous bone, 208 total navigated drilling trials were performed, using four different sized drill bits (2.5, 3.2, 3.5, and 4.5 mm) with and without the alignment device. Drilling tracts of 80 mm were made towards an intended target on the other side of the block. Reduction in deviation from the intended target was significantly improved with the use of the guide, ranging from 33% to 45% for the four drill sizes. For the trails using the alignment device, the 2.5-mm drill bit was significantly less accurate than the three larger drills. Our results demonstrate that the use of external devices to augment drill bit stabilization can improve drilling accuracy. This may have particular importance when using navigation systems to drill into small anatomic confines.
钻孔操作在骨科手术中很常见，是一项可以借助计算机辅助导航的特定任务。然而，钻头弯曲的固有灵活性可能使其成为使用这些系统时实现可接受精度的限制因素。我们设计了一种适配标准骨科钻头的对准装置，该装置可延长钻头的稳定点。在与松质骨密度相似的泡沫块中，使用四种不同尺寸的钻头（2.5、3.2、3.5和4.5毫米），在有和没有对准装置的情况下进行了总共208次导航钻孔试验。朝着泡沫块另一侧的预定目标钻出80毫米的钻孔轨迹。使用导向装置后，与预定目标的偏差明显减小，四种钻头尺寸的偏差减小范围为33%至45%。对于使用对准装置的试验，2.5毫米的钻头精度明显低于三种较大尺寸的钻头。我们的结果表明，使用外部装置增强钻头稳定性可提高钻孔精度。在使用导航系统钻入小解剖区域时，这可能尤为重要。
