Ma Burton, Kunz Manuela, Gammon Braden, Ellis Randy E, Pichora David R
Department of Electrical Engineering and Computing Science, York University, Toronto, ON, Canada,
Int J Comput Assist Radiol Surg. 2014 Jul;9(4):713-24. doi: 10.1007/s11548-013-0966-8. Epub 2013 Dec 10.
This article presents the results of a multiuser, randomized laboratory trial comparing the accuracy and precision of image-based navigation against individualized guides for distal radius osteotomy (DRO).
Six surgeons each performed four DROs using image-based navigation and four DROs using individualized guides in a laboratory setting with plastic phantom replicas of radii from patients who had received DRO as treatment for radial deformity. Time required and correction errors of ulnar variance, radial inclination, and volar tilt were measured.
There were no statistically significant differences in the average correction errors. There was a statistically significant difference in the standard deviation of ulnar variance error (2.0 mm for navigation vs. 0.6 mm for guides). There was a statistically significant difference in the standard deviation of radial inclination error ([Formula: see text] for navigation vs. [Formula: see text] for guides). There were statistically significant differences in the times required (705 s for navigation vs. 214 s for guides) and their standard deviations (144 s for navigation vs. 98 s for guides).
Compared to navigated DRO, individualized guides were easier to use, faster, and produced more precise correction of ulnar variance and radial inclination. The combination of true three-dimensional planning, ease of use, and accurate and precise corrective guidance makes the individualized guide technique a promising approach for performing corrective osteotomy of the distal radius.
本文介绍了一项多用户随机实验室试验的结果,该试验比较了基于图像的导航与个体化导向器在桡骨远端截骨术(DRO)中的准确性和精确性。
六名外科医生在实验室环境中,使用接受过DRO治疗桡骨畸形患者的桡骨塑料模型复制品,分别采用基于图像的导航进行四次DRO手术,以及采用个体化导向器进行四次DRO手术。测量所需时间以及尺骨变异、桡骨倾斜和掌倾角的矫正误差。
平均矫正误差无统计学显著差异。尺骨变异误差的标准差有统计学显著差异(导航为2.0毫米,导向器为0.6毫米)。桡骨倾斜误差的标准差有统计学显著差异(导航为[公式:见原文],导向器为[公式:见原文])。所需时间及其标准差有统计学显著差异(导航为705秒,导向器为214秒)以及(导航为144秒,导向器为98秒)。
与导航DRO相比,个体化导向器使用更简便、速度更快,并且能更精确地矫正尺骨变异和桡骨倾斜。真正的三维规划、易用性以及准确精确的矫正引导相结合,使得个体化导向器技术成为进行桡骨远端矫正截骨术的一种有前景的方法。