Elena Marie Loschan1,2, Padhraig O'Loughlin3, Christian Krettek2, Ralph Gaulke4,2. 1. Section Upper Extremity, Foot- and Rheuma Surgery, Trauma Department, Medical School Hanover (MHH), Hannover, Germany. 2. Trauma Department, Medical School Hanover (MHH), Hannover, Germany. 3. Mater Hospital, Citygate, Mahon, Cork, Ireland. 4. Section Upper Extremity, Foot- and Rheuma Surgery, Trauma Department, Medical School Hanover (MHH), Hannover, Germany gaulke.ralph@mh-hannover.de.
Abstract
BACKGROUND/AIM: In extensive soft tissue injury, primary internal fracture fixation is not always possible and external fixation for primary immobilization plays an important role. The aim of this study was to compare the accuracy of freehand technique and of a target device for retrograde calcaneotibial fixation in an uninjured bone and an unstable ankle fracture. MATERIALS AND METHODS: The calcaneotibial fixation was performed randomly by an experienced surgeon utilizing either a freehand drilling technique or a novel targeting device in four human cadavers before and after producing a bimalleolar ankle fracture. The duration of foot positioning, drilling, number of intensifier shots, and drilling attempts were recorded. The final position of the wire was established using IsoC-3D scan. RESULTS: The mean for definitive wire placement with the target device was 247 sec with a mean of 3.4 attempts, and 92 sec and 2.1 attempts in the freehand technique. Mean intraosseous distance of the K-wire was 45.3 mm and 63.6 mm in the tibia and 39.7 mm and 41.5 mm in the calcaneus respectively. CONCLUSION: The novel target device for calcaneotibial fixation achieves similar results to a trained surgeon using the freehand technique. Copyright
BACKGROUND/AIM: In extensive soft tissue injury, primary internal fracture fixation is not always possible and external fixation for primary immobilization plays an important role. The aim of this study was to compare the accuracy of freehand technique and of a target device for retrograde calcaneotibial fixation in an uninjured bone and an unstable ankle fracture. MATERIALS AND METHODS: The calcaneotibial fixation was performed randomly by an experienced surgeon utilizing either a freehand drilling technique or a novel targeting device in four human cadavers before and after producing a bimalleolar ankle fracture. The duration of foot positioning, drilling, number of intensifier shots, and drilling attempts were recorded. The final position of the wire was established using IsoC-3D scan. RESULTS: The mean for definitive wire placement with the target device was 247 sec with a mean of 3.4 attempts, and 92 sec and 2.1 attempts in the freehand technique. Mean intraosseous distance of the K-wire was 45.3 mm and 63.6 mm in the tibia and 39.7 mm and 41.5 mm in the calcaneus respectively. CONCLUSION: The novel target device for calcaneotibial fixation achieves similar results to a trained surgeon using the freehand technique. Copyright