Computer-assisted navigation of volar percutaneous scaphoid placement

Area of Science:

• Orthopedic surgery
• Medical technology
• Surgical navigation

Background:

• Scaphoid fractures are common, often treated with percutaneous screw fixation.
• Traditional techniques can involve significant radiation exposure and multiple attempts for accurate K-wire placement.
• Minimally invasive techniques aim to improve outcomes and reduce complications.

Purpose of the Study:

• To evaluate a computer-assisted navigation technique for retrograde percutaneous scaphoid screw insertion.
• To compare insertion time, accuracy, and radiation exposure against the traditional method.
• To test the hypothesis that computer-assisted navigation improves accuracy, reduces time, and lowers radiation exposure.

Main Methods:

• Ten matched pairs of cadaveric wrists were randomized to computer-assisted or traditional volar percutaneous scaphoid screw placement.
• Procedure time, set-up time, K-wire placement time, and radiation time were recorded.
• K-wire attempts and accuracy of screw axis placement were assessed; statistical analysis used Student's t-tests and rank sums (alpha=0.05).

Main Results:

• Overall procedure and set-up times were not significantly different between groups.
• Computer-assisted technique halved K-wire placement time and reduced K-wire attempts, approaching clinical significance.
• Radiation exposure was clinically significantly reduced during the overall procedure, K-wire placement, and screw placement with computer-assisted navigation.

Conclusions:

• Computer-assisted navigation for scaphoid screw placement is comparable in time to traditional methods.
• This technique significantly reduces patient radiation exposure.
• It also shows a trend towards fewer K-wire passes, improving procedural efficiency and safety.