Department of Clinical Sciences in Veterinary Medicine, Mississippi State University, Starkvilln, Mississippi, USA.
Michigan State University, East Lansing, Michigan, USA.
Vet Surg. 2023 May;52(4):538-544. doi: 10.1111/vsu.13952. Epub 2023 Mar 16.
(1) To evaluate the accuracy of an aiming device on placement of humeral transcondylar screws compared to fluoroscopic methods. (2) To compare experience level on outcome.
Randomized, match pair, prospective ex-vivo study.
A total of 68 dogs.
Canine cadaveric forelimbs were randomly assigned to either aiming device or fluoroscopic-guided groups, and to diplomate or resident. Digital radiography was used to evaluate screw trajectory deviation and eccentricity on the humeral condyle. Procedure time, outcome based on experience, and complications were recorded.
The aiming device screw trajectory angle was decreased in the right limb (1.9 ± 1.1°) compared with the left (3.6 ± 1.1°, p = .0178), and compared to fluoroscopy (3.4 ± 1.1° p = .0128). There was no difference between leg laterality with fluoroscopy (p = .9979). Trajectory angle was increased with resident versus diplomate (3.4 ± 1.1° and 2.5 ± 1.1° respectively, p = .0366). Eccentricity deviation was decreased using fluoroscopy versus aiming device (3.1 ± 0.36 mm, 4.2 ± 0.36 mm, respectively, p = .0017). The risk of joint involvement was 8 times greater in aiming device groups, though not significant (p = .0575). Significant complications included increased drill attempts in fluoroscopic groups (p = .0237).
The aiming device provided accurate placement of transcondylar screws, in terms of both position on the condyle and trajectory angle. Results were similar to fluoroscopic-guided method.
An aiming device is an acceptable means of placing humeral transcondylar screws. The use of the aiming device had an eight times increased risk of joint involvement compared to fluoroscopy.
（1）评估瞄准器在肱骨髁间钉放置中的准确性，与透视方法进行比较。（2）比较经验水平对结果的影响。
随机、配对、前瞻性离体研究。
共 68 只狗。
将犬前肢尸体随机分配到瞄准器组或透视引导组，并分配给专科医生或住院医生。数字射线照相术用于评估肱骨髁上螺钉轨迹偏差和偏心度。记录手术时间、基于经验的结果和并发症。
与左侧（3.6 ± 1.1°）相比，右侧（1.9 ± 1.1°）使用瞄准器的螺钉轨迹角度减小（p =.0178），与透视相比（3.4 ± 1.1°，p =.0128）。使用透视时，肢体侧位无差异（p =.9979）。与专科医生相比，住院医生的轨迹角度增加（分别为 3.4 ± 1.1°和 2.5 ± 1.1°，p =.0366）。与瞄准器相比，使用透视时偏心度偏差减小（3.1 ± 0.36 mm，4.2 ± 0.36 mm，分别为 p =.0017）。尽管没有统计学意义（p =.0575），但瞄准器组关节受累的风险增加了 8 倍。显著并发症包括透视组增加了钻孔尝试（p =.0237）。
瞄准器在髁上位置和轨迹角度方面都提供了准确的髁间钉放置。结果与透视引导方法相似。
瞄准器是一种可接受的肱骨髁间钉放置方法。与透视相比，使用瞄准器关节受累的风险增加了 8 倍。
