Navigated treatment of metatarsal V fractures using a new image based guidance system

• Published in: The international journal of medical robotics + computer assisted surgery 2012-12, Vol.8 (4), p.441-447
• Main Authors: Kraus, Michael, Dehner, Christoph, Riepl, Christoph, Krischak, Gert, Gebhard, Florian, Schöll, Hendrik
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bone Wires; computer assisted surgery; Fluoroscopy - instrumentation; Foot Injuries - surgery; foot injury; Fracture Fixation, Internal - instrumentation; Fractures, Bone - surgery; Humans; image guidance; K-wire fixation; Metatarsal Bones - injuries; Metatarsal Bones - surgery; metatarsal V fracture; Middle Aged; Minimally Invasive Surgical Procedures - instrumentation; Orthopedic Procedures - instrumentation; Prospective Studies; Robotics - instrumentation; Surgery, Computer-Assisted - instrumentation; Young Adult
• ISSN: 1478-5951; 1478-596X
• DOI: 10.1002/rcs.1450

Background Computer assisted imaging systems are rarely used for fracture treatment and foot surgery. We introduce a new system for image based guidance in traumatology. Methods We included 20 patients with a fracture of the fifth metatarsal. They were randomized on admission into two groups. Ten patients in the metatarsal group were operated conventionally and ten were operated with the assistance of a new image guidance system. This system is based on 2D‐fluoro images which are acquired with a conventional c‐arm and are transferred to the system workstation. After detecting marked tools, it can be used to display trajectories for K‐wire guidance in the c‐arm shot. Results The average duration of surgery in the image‐guided group was 12.7 minutes. In the conventional treated group, it was 17 minutes. The average duration of radiation was 18 seconds in the image‐guided group vs. 32.4 seconds in the conventional group. 1.6 trials were necessary to position the K‐wire for image‐guided procedures in comparison to 2.7 trials in the conventional group. Conclusion Image‐based guidance systems can be used for indications, were hitherto existing navigation systems are limited due to their dependence on fixed reference devices. Image‐guided systems can be integrated into existing workflows and can reduce the malpositioning of guidewires. Copyright © 2012 John Wiley & Sons, Ltd.