Goyal Nishant D, Panchnadikar Vijay M
Department of Orthopaedics, Max Institute of Musculoskeletal Sciences, New Delhi, India.
Shri Vasantrao Naik Government Medical College and Hospital, Yavatmal, Maharashtra India.
Indian J Orthop. 2021 May 24;55(Suppl 2):466-472. doi: 10.1007/s43465-021-00422-5. eCollection 2021 Jul.
BACKGROUND: Computer-assisted navigation system is well-known orthopaedic advancement which allow surgeon to obtain a real-time feedback during surgeries, thus helps to reduce intraoperative errors. Currently used navigation systems are tracker based, invasive and non-universal. Therefore this study was conducted to test novel tracker-less, image-based, non-invasive, universal, real-time navigation system to predict future position of the guide wire, K wire, screws and plates in orthopaedic trauma surgeries. METHODS: Firstly, the software was tested and validated on bone model. Then utilized for non-randomised comparative study conducted on 81 adult patients with stable intertrochanteric fracture treated by dynamic hip screw and barrel plate fixation. In one group, C-arm was used and in other, software navigation was used in addition to C-arm. Parameters such as time to insertion, number of C-arm shoots and number of attempts for guide wire insertion were documented and compared. RESULTS: Use of the navigation software for guide wire positioning in bone models and in the DHS barrel plate surgery proved to be significantly beneficial as compared to not using navigation. CONCLUSION: Intraoperative use of this new navigation system eliminates trial and error improving accuracy and reducing the operative time and radiation exposure. Thus this novel trackerless, C-arm image-based navigation system have potential to replace existing tracker-based navigation systems because of its universal nature, noninvasive and more effective properties.
背景:计算机辅助导航系统是著名的骨科技术进步,它能让外科医生在手术过程中获得实时反馈,从而有助于减少术中误差。目前使用的导航系统基于追踪器,具有侵入性且不通用。因此,本研究旨在测试一种新型的无追踪器、基于图像、非侵入性、通用的实时导航系统,以预测骨科创伤手术中导丝、克氏针、螺钉和钢板的未来位置。 方法:首先,该软件在骨模型上进行测试和验证。然后用于对81例采用动力髋螺钉和桶状钢板固定治疗的稳定型股骨转子间骨折成年患者进行的非随机对照研究。一组使用C形臂,另一组除C形臂外还使用软件导航。记录并比较诸如插入时间、C形臂拍摄次数和导丝插入尝试次数等参数。 结果:与不使用导航相比,在骨模型和动力髋螺钉桶状钢板手术中使用导航软件进行导丝定位被证明具有显著优势。 结论:术中使用这种新的导航系统消除了试错过程,提高了准确性,减少了手术时间和辐射暴露。因此,这种新型的无追踪器、基于C形臂图像的导航系统因其通用性、非侵入性和更高的有效性,有潜力取代现有的基于追踪器的导航系统。
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