Computer navigation-assisted minimally invasive percutaneous screw placement for pelvic fractures

Yu, Tong; Cheng, Xueliang; Qu, Yang; Dong, Ran; Kang, Mingyang; Zhao, Jianwu

doi:10.12998/wjcc.v8.i12.2464

Cited by 13 publications

(8 citation statements)

References 57 publications

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“…Computerized virtual surgery planning has been increasingly applied in various orthopedic procedures. Three-dimensional (3D) preoperative planning and intraoperative navigation systems are clinically utilized for fracture management [ 1 , 2 , 3 , 4 , 5 ]. 3D preoperative planning is useful for pre-processing visualization, understanding fracture displacement, and selecting surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

An Experimental Study of a 3D Bone Position Estimation System Based on Fluoroscopic Images

Yoshii

Iwahashi²,

Sashida³

et al. 2022

Diagnostics

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To compare a 3D preoperative planning image and fluoroscopic image, a 3D bone position estimation system that displays 3D images in response to changes in the position of fluoroscopic images was developed. The objective of the present study was to evaluate the accuracy of the estimated position of 3D bone images with reference to fluoroscopic images. Bone positions were estimated from reference points on a fluoroscopic image compared with those on a 3D image. The four reference markers positional relationships on the fluoroscopic image were compared with those on the 3D image to evaluate whether a 3D image may be drawn by tracking positional changes in the radius model. Intra-class correlations coefficients for reference marker distances between the fluoroscopic image and 3D image were 0.98–0.99. Average differences between measured values on the fluoroscopic image and 3D bone image for each marker corresponding to the direction of the bone model were 1.1 ± 0.7 mm, 2.4 ± 1.8 mm, 1.4 ± 0.8 mm, and 2.0 ± 1.6 mm in the anterior-posterior view, ulnar side lateral view, posterior-anterior view, and radial side lateral view, respectively. Marker positions were more accurate in the anterior-posterior and posterior-anterior views than in the radial and ulnar side lateral views. This system helps in real-time comparison of dynamic changes in preoperative 3D and intraoperative fluoroscopy images.

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Section: Introductionmentioning

confidence: 99%

An Experimental Study of a 3D Bone Position Estimation System Based on Fluoroscopic Images

Yoshii

Iwahashi²,

Sashida³

et al. 2022

Diagnostics

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“…Considerations are being given to role of CT Guided/Navigated Screw insertion to maximize the utilization of corridors for screw fixation. 65 Also custom made cups with clustering of screw holes in the direction of corridors and use of screw augmentation technology with polymethyl methacrylate can be used. 15…”

Section: Future Directionsmentioning

confidence: 99%

Total hip arthroplasty in acetabular fractures

Gautam

Gupta

Malhotra

2020

Journal of Clinical Orthopaedics and Trauma

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Total Hip Arthroplasty (THA) is a well-accepted treatment for established hip arthritis following acetabular fractures. If a conservatively managed or operated case progresses to non-union/mal-union failing to restore the joint integrity, it may eventually develop secondary arthritis warranting a total hip arthroplasty. Also, in recent years, acute total hip arthroplasty is gaining importance in conditions where the fracture presents with pre-existing hip arthritis, is not amenable to salvage by open reduction and internal fixation, or, a poor prognosis is anticipated following fixation.There are several surgical challenges in performing total hip arthroplasty for acetabular fractures whether acute or delayed. As a separate entity elderly patients pose a distinct challenge due to osteoporosis and need stable fixation for early weight bearing alleviating the risk of any thromboembolic event, pulmonary complications and decubitus ulcer. The aim of surgery is to restore the columns for acetabular component implantation rather than anatomic fixation. Meticulous preoperative planning with radiographs and Computed Tomography (CT) scans, adequate exposure to delineate the fracture pattern, and, availability of an array of all instruments and possible implants as backup are the key points for success. Previous implants if any should be removed only if they are in the way of cup implantation or infected. Press fit uncemented modern porous metal acetabular component with multiple screw options is the preferred implant for majority of cases. However, complex fractures may require major reconstruction with revision THA implants especially when a pelvic discontinuity is present.

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“…86,87 For patients with iliac dysplasia, navigation-assisted screw implantation has more significant precision than regular screw implantation. 88,89 Clinical Question 20: How to Diagnose and Treat for Pelvic Insufficiency Fracture? Recommendation 20: X-ray, CT, bone scan and MRI should be checked for elderly patients with severe pelvic pain and immobilization, and conservative care and minimally invasive fixation are recommended.…”

Section: Clinical Question 19: What Are the Common Posteriormentioning

confidence: 99%

“…Compared to unilateral iliosacral screws, transsacral screws do not induce additional pain or functional damage 86,87 . For patients with iliac dysplasia, navigation‐assisted screw implantation has more significant precision than regular screw implantation 88,89 …”

Section: Clinical Questionsmentioning

confidence: 99%

Clinical Guidelines for the Diagnosis and Treatment of Fragility Fractures of the Pelvis

Zhang

et al. 2023

Orthopaedic Surgery

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BackgroundFragility fractures of the pelvis (FFPs) are osteoporotic pelvic fractures or insufficiency pelvic fractures caused by the low energy injury or stress fracture in daily livings in the elderly more than 60 years, which the incidence is increasing with the aging population in our country. FFPs result in considerable morbidity and mortality and as well as massive financial burden on the already strained health systems throughout the world.MethodsThis clinical guideline was initiated by the Trauma Orthopedic Branch of Chinese Orthopedic Association; the External Fixation and Limb Reconstruction Branch of Chinese Orthopedic Association; the National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation; Senior Department of Orthopedics of Chinese PLA general hospital; the Third Hospital of Hebei Medical University. The grading of recommendations assessment, development and evaluation (GRADE) approach and the reporting items for practice guidelines in healthcare (RIGHT) checklist were adopted.Results22 evidence based recommendations were formulated based on 22 most concerned clinical problems among orthopedic surgeons in China.ConclusionUnderstanding these trends through this guideline will facilitate better clinical care of FFP patients by medical providers and better allocation of resources by policy makers.

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Computer navigation-assisted minimally invasive percutaneous screw placement for pelvic fractures

Cited by 13 publications

References 57 publications

An Experimental Study of a 3D Bone Position Estimation System Based on Fluoroscopic Images

An Experimental Study of a 3D Bone Position Estimation System Based on Fluoroscopic Images

Total hip arthroplasty in acetabular fractures

Clinical Guidelines for the Diagnosis and Treatment of Fragility Fractures of the Pelvis

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