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Hinged external fixator placement at the elbow: navigated versus conventional technique.

C C Egidy¹, D Fufa, D Kendoff

¹Orthopaedic Department, Helios-Endo Klinik Hamburg, Hamburg, Germany.

Computer Aided Surgery : Official Journal of the International Society for Computer Aided Surgery

|October 27, 2012

Summary

Computerized navigation improves accuracy and reduces drilling attempts for hinged external elbow fixator pin placement. This technique offers better precision than conventional fluoroscopy, simplifying the procedure.

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Area of Science:

Orthopedic surgery
Medical device technology
Surgical navigation systems

Background:

Accurate placement of the central axis pin in hinged external elbow fixators is challenging.
Conventional methods often require multiple drilling attempts and fluoroscopic localization, increasing procedure time.

Purpose of the Study:

To evaluate the effectiveness of computerized navigation in improving the precision of central axis pin placement for elbow fixators.
To determine if navigation reduces the number of drilling attempts compared to conventional fluoroscopic guidance.

Main Methods:

Twelve elbow models with soft tissue coverage were used.
Optimal placement trajectory (OPJ) was defined for each model.
Computerized navigation and conventional fluoroscopy were compared in two groups of six specimens each.
Measurements included AP angulation and lateral distance deviations from the OPJ, and the number of drilling attempts.

Main Results:

The navigation group showed all cases within 20° of the optimal AP angulation, compared to half in the conventional group.
Mean lateral distance deviation was significantly lower in the navigation group (1.83 mm) versus the conventional group (3.83 mm; p=0.042).
All navigated cases required only one drilling attempt for optimal axial pin placement.

Conclusions:

Two-dimensional navigation significantly reduces drilling attempts for elbow fixator axis pin placement.
Computerized navigation offers superior accuracy in AP angulation and lateral distance compared to conventional techniques.