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2D projection-based software application for mobile C-arms optimises wire placement in the proximal femur - An
B Swartman1, D Frere1, W Wei2
1BG-Klinik Ludwigshafen, MINTOS Research Group, Clinic for Trauma Surgery and Orthopaedics, Trauma Surgery Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany.
Injury
|August 5, 2017
Summary
A new software application improved Kirschner wire (K-wire) placement in the proximal femur. This tool reduced procedure time, fluoroscopy exposure, and increased precision, enhancing surgical efficiency and patient safety.
Area of Science:
- Orthopedic surgery
- Medical imaging technology
- Surgical navigation systems
Background:
- Accurate Kirschner wire (K-wire) placement is crucial for proximal femur fracture fixation.
- Conventional K-wire placement relies on freehand techniques and fluoroscopic guidance, which can be time-consuming and involve radiation exposure.
- The development of image-guided surgical tools aims to improve accuracy and efficiency in orthopedic procedures.
Purpose of the Study:
- To compare the efficacy of a novel software application for K-wire placement in the proximal femur against the conventional method.
- To evaluate the impact of the software on the number of placement attempts, procedure duration, and fluoroscopy time.
- To assess the precision of K-wire placement using the software compared to traditional techniques.
Main Methods:
- A software application was developed to detect K-wires in 2D fluoroscopic images and visualize the intended trajectory.
- K-wires were placed into 20 artificial proximal femur models using the software and 20 controls using the conventional method.
- Data collected included: number of placement attempts, procedure duration, fluoroscopy time, and postoperative 3D scan precision.
Main Results:
- The software application group demonstrated significantly fewer K-wire placement attempts (p=0.026).
- Shorter surgical procedure duration (p=0.004) and reduced fluoroscopy time (p=0.024) were observed with the software.
- Higher precision in K-wire placement was achieved with the software (p=0.018), with 17/20 cases achieving first-attempt success.
Conclusions:
- The study hypothesis was confirmed: the software application optimizes K-wire placement in the proximal femur.
- The novel software improves surgical efficiency by reducing placement attempts and procedure time.
- Enhanced precision and reduced fluoroscopy time highlight the software's benefits for radiation protection and surgical outcomes.
