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Wire Placement in the Sustentaculum Tali Using a 2D Projection-Based Software Application for Mobile C-Arms:
Benedict Swartman1, Dirk Frere1, Wei Wei2
11 BG-Klinik Ludwigshafen, Clinic for Trauma Surgery and Orthopaedics, Trauma Surgery Clinic at Heidelberg University, Ludwigshafen, Germany.
Foot & Ankle International
|January 20, 2018
Summary
A new software tool aids inexperienced surgeons in placing Kirschner wires (K-wires) for sustentaculum tali fixation, reducing attempts. However, experienced surgeons did not benefit from this novel application in cadaver studies.
Area of Science:
- Orthopedic surgery
- Surgical navigation technology
Background:
- Indirect screw fixation of the sustentaculum tali presents anatomical challenges.
- A novel 2D software visualizes Kirschner wire (K-wire) trajectories for improved guidance.
Purpose of the Study:
- To evaluate the efficacy of a novel 2D projection-based software in facilitating indirect K-wire placement in the sustentaculum tali.
- To compare surgical outcomes with and without the software in both experienced and inexperienced surgeons.
Main Methods:
- A prospectively randomized cadaver study involving 20 foot specimens.
- K-wires were placed by experienced and inexperienced surgeons, with and without the software.
- Data collected included placement attempts, procedure duration, fluoroscopy time, and image counts; wire position was analyzed via 3D C-arm scans.
Main Results:
- The software significantly reduced K-wire placement attempts for the inexperienced surgeon (3.2 to 1.2, P = .006).
- Operating and fluoroscopy times showed non-significant reductions for the inexperienced surgeon (P = .15).
- The experienced surgeon showed non-significant increases in operating time, fluoroscopy time, and image counts when using the software (P > .15).
Conclusions:
- The software is a beneficial tool for inexperienced surgeons performing indirect K-wire placement in the sustentaculum tali.
- Experienced surgeons did not demonstrate significant benefits from using the software in this study setting.
- The software shows potential for various orthopedic fracture fixations, including femur, sacrum, and foot/ankle injuries.
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