BACKGROUND: Minimally invasive ostesynthesis of scaphoid fractures may reduce the risk of fracture non-union and shorten the duration of illness. The aim of this study was to analyze the technical feasibility and targeting accuracy of computed tomography (CT) - guided stereotactic Kirschner (K)-wire positioning in the scaphoid. METHODS: Nineteen Formalin preserved cadaveric upper extremities (10 right, 9 left) were fixed in 90 degree dorsal extension for percutaneous access from palmar. An ideal central position of the K-wire was planned on the computer adapted from intraoperative CT data. A 3D navigation system and stereotactic targeting device were used for K-wire placement. Target positioning errors were evaluated by fusion of the control CT with the K-wire in place with the planning CT. RESULTS: The procedure allowed for an easy and rigid wrist fixation. K-wire placement showed mean ± SD lateral targeting errors of 0.9 ± 0.5 mm at the scaphoid bone entry and 1.2 ± 0.7 mm at the K-wire tip. The mean angular error was 1.3° ± 1.1° . Total duration of the intervention ranged between 19 and 23 min. CONCLUSION: CT-guided stereotactic K-wire placement in scaphoid bones is highly accurate. The technique may guide minimally invasive screw-osteosynthesis of scaphoid fractures.
BACKGROUND: Minimally invasive ostesynthesis of scaphoid fractures may reduce the risk of fracture non-union and shorten the duration of illness. The aim of this study was to analyze the technical feasibility and targeting accuracy of computed tomography (CT) - guided stereotactic Kirschner (K)-wire positioning in the scaphoid. METHODS: Nineteen Formalin preserved cadaveric upper extremities (10 right, 9 left) were fixed in 90 degree dorsal extension for percutaneous access from palmar. An ideal central position of the K-wire was planned on the computer adapted from intraoperative CT data. A 3D navigation system and stereotactic targeting device were used for K-wire placement. Target positioning errors were evaluated by fusion of the control CT with the K-wire in place with the planning CT. RESULTS: The procedure allowed for an easy and rigid wrist fixation. K-wire placement showed mean ± SD lateral targeting errors of 0.9 ± 0.5 mm at the scaphoid bone entry and 1.2 ± 0.7 mm at the K-wire tip. The mean angular error was 1.3° ± 1.1° . Total duration of the intervention ranged between 19 and 23 min. CONCLUSION: CT-guided stereotactic K-wire placement in scaphoid bones is highly accurate. The technique may guide minimally invasive screw-osteosynthesis of scaphoid fractures.
Authors: Erin J Smith; Gregory Allan; Braden Gammon; Richard W Sellens; Randy E Ellis; David R Pichora Journal: Int J Comput Assist Radiol Surg Date: 2013-04-16 Impact factor: 2.924
Authors: G Caiti; J G G Dobbe; S D Strackee; M H M van Doesburg; G J Strijkers; G J Streekstra Journal: Int J Comput Assist Radiol Surg Date: 2021-01-21 Impact factor: 2.924