Gardner Michael J, Citak Musa, Kendoff Daniel, Hüfner Tobias, Krettek Christian
Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
Injury. 2007 Jul;38(7):755-8. doi: 10.1016/j.injury.2007.02.031. Epub 2007 May 30.
Computer navigation in orthopaedic procedures can improve accuracy and decrease radiation time compared to traditional fluoroscopy. Many different applications are now available, and drilling is commonly used amongst them. Aside from additional set up time required, the drilling procedure itself may take a significant amount of time. We hypothesised that using an external stabilising guide which can be set anywhere in space can decrease then time necessary for navigated drilling.
Foam blocks, 80 mm in length and a density similar to cancellous bone, were obtained. Small discs were placed on one end as drilling targets. Using an Iso-C 3D navigation system, 20 navigated drilling trials were performed under each of two conditions: freehand, and with the use of a drill stabilising guide attached to an operating table. The time and accuracy of the two methods were compared.
The time required for the entire navigation procedure was significantly less using the stabilising arm compared to drilling freehand with navigation (4.5 min versus 5.8 min, p=0.009). There was no significant difference in accuracy between the two methods.
Using a guide which attaches to the table and allows the surgeon to fix the drill sleeve when the desired vector is chosen allows for faster navigated drilling. This was easy to set up and attach to the table, and did not diminish accuracy of drilling an intended target.
与传统的荧光透视法相比，骨科手术中的计算机导航可以提高准确性并减少辐射时间。现在有许多不同的应用，其中钻孔是常用的。除了需要额外的设置时间外，钻孔过程本身可能会花费大量时间。我们假设使用一种可以设置在空间中任何位置的外部稳定导向器可以减少导航钻孔所需的时间。
获取长度为80毫米、密度与松质骨相似的泡沫块。在一端放置小圆盘作为钻孔目标。使用Iso-C 3D导航系统，在两种条件下分别进行20次导航钻孔试验：徒手操作，以及使用连接到手术台的钻孔稳定导向器。比较两种方法的时间和准确性。
与徒手导航钻孔相比，使用稳定臂进行整个导航过程所需的时间明显更少（4.5分钟对5.8分钟，p=0.009）。两种方法在准确性上没有显著差异。
使用一种连接到手术台并允许外科医生在选择所需矢量时固定钻套的导向器，可以实现更快的导航钻孔。这很容易设置并连接到手术台，并且不会降低钻至预定目标的准确性。
