Improving the Accuracy of Metatarsal Osteotomies in Minimally Invasive Foot Surgery Using a Digital Inclinometer: Preliminary Study

Fernández-Vizcaino, Carlos; Nieto-García, Eduardo; Fernández-Ehrling, Nadia; Ferrer-Torregrosa, Javier

doi:10.3390/s24031022

Cited by 3 publications

(4 citation statements)

References 39 publications

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“…Drilling was also performed in a direction determined by a combination of inclination and anteversion angles, and mean absolute errors of 0.35 ± 0.25 and 2 ± 1.33 degrees were obtained for the inclination and anteversion angles, respectively. The results obtained using a sensor-guided approach were similar or better than those reported in other studies utilizing digital angle measurement tools [ 20 , 25 , 27 ].…”

Section: Discussionsupporting

confidence: 83%

“…The studies on the use of digital tools for help in angle estimation during surgery are scarce [ 25 , 27 , 28 ], and even in those studies, estimation is usually provided only for angles confined to a single plane, most often for the inclination angle. This can be due to limitations of the tools, such as in the study by Park et al, where a digital goniometer was used to assess the angle of insertion of Kirschner wires [ 25 ], or the nature of the surgical procedure [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have shown that the estimation of angles using just visual estimates is very inaccurate [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. Nevertheless, reports on the use of digital tools for angle estimation are scarce and mostly focus on estimating angles restricted to a single plane [ 25 , 26 , 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Smart Drill for a Streamlined Estimation of the Drilling Angle and Channel Length in Orthopedic Surgical Procedures

Ivanišević,

Boban,

Jurić

et al. 2024

Bioengineering

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The estimation of distances and angles is a routine part of an orthopedic surgical procedure. However, despite their prevalence, these steps are most often performed manually, heavily relying on the surgeon’s skill and experience. To address these issues, this study presents a sensor-equipped drill system which enables automatic estimation of the drilling angle and channel length. The angular accuracy and precision of the system were tested over a range of inclination angles and proved to be superior to the manual approach, with mean absolute errors ranging from 1.9 to 4.5 degrees for the manual approach, and from 0.6 to 1.3 degrees with the guided approach. When sensors were used for simultaneous estimation of both the inclination and anteversion angles, the obtained mean absolute errors were 0.35 ± 0.25 and 2 ± 1.33 degrees for the inclination and anteversion angles, respectively. Regarding channel length estimation, using measurements obtained with a Vernier caliper as a reference, the mean absolute error was 0.33 mm and the standard deviation of errors was 0.41 mm. The obtained results indicate a high potential of smart drill systems for improvement of accuracy and precision in orthopedic surgical procedures, enabling better patient clinical outcomes.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Smart Drill for a Streamlined Estimation of the Drilling Angle and Channel Length in Orthopedic Surgical Procedures

Ivanišević,

Boban,

Jurić

et al. 2024

Bioengineering

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“…In 15 patients the same surgery was performed, but using a goniometer to perform the osteotomy at the same 45 • angulation [25] (Figure 3).…”

Section: Digital Goniometer Subgroupmentioning

confidence: 99%

Impact of Minimally Invasive Intra-Capsular Metatarsal Osteotomy on Plantar Pressure Decrease: A Cross-Sectional Study

Fernández-Vizcaino,

Naranjo-Ruiz,

Fernández-Ehrling

et al. 2024

JCM

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Background: Metatarsalgia is a common pathology that is initially treated conservatively, but failure to do so requires surgery, such as the minimally invasive distal metatarsal osteotomy (DICMO). Methods: In this prospective study of 65 patients with primary metatarsalgia who underwent DICMO, plantar pressures, American Orthopaedic Foot and Ankle Society MetaTarsoPhalangeal-InterPhalangeal scale (AOFAS-MTP-IP) and Visual Analog Scale (VAS) were evaluated pre-operatively and post-operatively and there was a subgroup in which an inclinometer was used to observe the importance of the inclination of the osteotomy. Results: The results show a significant reduction in plantar pressures after DICMO surgery without overloading the adjacent radii, especially in the subgroup with an inclinometer to guide the osteotomy. The AOFAS-MTP-IP scale evidenced a marked improvement in metatarsal function and alignment with scores close to normal. The VAS scale showed a substantial decrease in pain after DICMO osteotomy. Conclusions: DICMO, with an inclinometer for a 45° osteotomy, proved to be a safe and effective procedure for primary metatarsalgia, although further comparative studies are needed to confirm its superiority.

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Surgical Precision of MICA and Reverdin-Isham Using 3D-Printed Guides: A Cadaveric Study

Fernández-Ehrling,

Nieto-García,

Ramirez-Andrés

et al. 2024

Medicina

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Background/Objectives: Hallux valgus is a common foot deformity that requires surgical correction to restore proper alignment. Precision in the osteotomies performed during these surgeries is critical to avoid complications and improve outcomes. However, variability in surgeon experience can negatively affect precision. In this context, advances in 3D printing have enabled the development of customized surgical guides, which may enhance precision and reduce variability among surgeons with different levels of expertise. This study aims to evaluate the effectiveness of a 3D-printed surgical guide in minimally invasive hallux valgus correction, focusing on the accuracy of osteotomies performed by novice surgeons, experienced surgeons, and theoretically trained consultants. Methods: An ex vivo study was performed with 30 cadaveric feet, divided into three groups according to the level of experience of the surgeons: 3D guide group, Master’s students, professionals. All surgeons performed Akin and Reverdin-Isham osteotomies, but the experimental group (the 3D guide group) utilized a customized 3D-printed surgical guide for enhanced precision during these procedures. Radiographic measurements of osteotomy angles and alignment were taken after the interventions, and compared with the planned values. Statistical analyses were conducted to evaluate the variability in the precision of the cuts. Results: The use of the 3D-printed surgical guide significantly reduced angular variability in the experienced group, achieving higher levels of accuracy than experienced surgeons. Effect sizes, which ranged from small to large, indicated a greater impact on angle measurements (η2 = 0.46, p < 0.001); no significant differences were found between the groups in other evaluated parameters. Conclusions: The incorporation of 3D-printed surgical guides in hallux valgus surgery significantly improves osteotomy accuracy, particularly in less experienced surgeons. This suggests that these guides can help standardize procedures, reduce the learning curve, and lower intraoperative complications.

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Improving the Accuracy of Metatarsal Osteotomies in Minimally Invasive Foot Surgery Using a Digital Inclinometer: Preliminary Study

Cited by 3 publications

References 39 publications

Smart Drill for a Streamlined Estimation of the Drilling Angle and Channel Length in Orthopedic Surgical Procedures

Smart Drill for a Streamlined Estimation of the Drilling Angle and Channel Length in Orthopedic Surgical Procedures

Impact of Minimally Invasive Intra-Capsular Metatarsal Osteotomy on Plantar Pressure Decrease: A Cross-Sectional Study

Surgical Precision of MICA and Reverdin-Isham Using 3D-Printed Guides: A Cadaveric Study

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