Next generation distal locking for intramedullary nails using an electromagnetic X-ray-radiation-free real-time navigation system

Hoffmann, Michael; Schröder, Matthias; Lehmann, Wolfgang; Kammal, Michael; Rueger, Johannes M.

doi:10.1097/ta.0b013e31824b0088

Cited by 34 publications

(29 citation statements)

References 18 publications

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“…For instance, it is an interesting option for enabling computer assistance during intramedullary nailing, a special bone fracture therapy in which the nail is inserted into the bone while line-of-sight is blocked [58]. Additionally, one study tested EM tracking in comparison to optical tracking for bone surgery [98].…”

Section: A Range Of Applicationmentioning

confidence: 99%

“…For feeding tube placement the CORTRAK R system (CORPAK Medsystems, Buffalo Grove, Illinois, USA) uses a transmitter inside the feeding tube and a mobile receiver unit attached to the torso of the patient [81]. For intramedullary nailing, the TRIGEN SURESHOT system (Smith&Nephew) tracks the intramedullary nail and uses a mobile FG to guide a drill [58].…”

Section: B Commercial Systemsmentioning

confidence: 99%

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Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Franz

Haidegger

Birkfellner

et al. 2014

IEEE Trans. Med. Imaging

401

273

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Abstract-Object tracking is a key enabling technology in the context of computer-assisted medical interventions. Allowing the continuous localization of medical instruments and patient anatomy, it is a prerequisite for providing instrument guidance to subsurface anatomical structures. The only widely used technique that enables real-time tracking of small objects without lineof-sight restrictions is electromagnetic (EM) tracking. While EM tracking has been the subject of many research efforts, clinical applications have been slow to emerge. The aim of this review paper is therefore to provide insight into the future potential and limitations of EM tracking for medical use. We describe the basic working principles of EM tracking systems, list the main sources of error, and summarize the published studies on tracking accuracy, precision and robustness along with the corresponding validation protocols proposed. State-of-the-art approaches to error compensation are also reviewed in depth. Finally, an overview of the clinical applications addressed with EM tracking is given. Throughout the paper, we report not only on scientific progress, but also provide a review on commercial systems. Given the continuous debate on the applicability of EM tracking in medicine, this paper provides a timely overview of the state-of-the-art in the field.

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Section: A Range Of Applicationmentioning

confidence: 99%

Section: B Commercial Systemsmentioning

confidence: 99%

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Franz

Haidegger

Birkfellner

et al. 2014

IEEE Trans. Med. Imaging

401

273

View full text Add to dashboard Cite

show abstract

“…Ciftdemir et al [19] reported that the mean time of image intensifier shots was 26.1 seconds, ranging from 16 to 41 seconds in the whole intramedullary nailing procedure used electromagnetic-manual guidance. Hoffmann et al [20] reported that the time for drilling the anteroposterior distal locking hole plus insertion of the screw was 84.04 s in the electromagnetic group and 186.22 s in the free-hand group. Uruc et al [5] reported that total fluoroscopy time and distal locking time were 48 seconds, 21 minutes for femoral fractures with an intramedullary nail in the free-hand group, whereas the time was 24 seconds, 8 minutes in the electromagnetic group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of femoral intramedullary nails

Han

Shi

et al. 2017

Medicine

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Background:Although the method has been used widely, one of the greatest challenges for intramedullary nailing is to position the distal locking screw. A new technology, the electromagnetic navigation system, is a radiation-free way to locate the position of the drill bit and provide 3-dimensional real-time feedback of location and orientation of the drill bit relative to the locking holes. The purpose of our study was to evaluate the reliability and efficiency of the free-hand technique compared to the new electromagnetic navigation system.Methods:Fifty-four patients with femoral fracture who needed treatment with intramedullary nails were divided into 2 groups. One group including 26 patients underwent distal locking using the standard free-hand method, whereas the electromagnetic navigation system was used with the other 29 patients. Intraoperative fluoroscopy exposure times, screw insertion times, and healing times were recorded; these parameters were used for comparison between the 2 groups.Results:There were 17 males and 9 females who had femoral intramedullary nails using the free-hand technique, whereas 21 males and 8 females received intramedullary nails using the electromagnetic navigation system. The mean time of distal locking was 19.5 ± 6.0 minutes in the free-hand (FH) group, whereas the time was 6.1 ± 1.4 minutes in the electromagnetic (ET) group. The exposure time for the FH group was 26.8 ± 13.3 seconds and 2.2 ± 1.1 seconds for the ET group. Healing time proved to be comparable in the FH and ET groups (16.4 ± 3.7 weeks vs 15.1 ± 2.8 weeks).Conclusion:Under the premise of achieving the same effect, the electromagnetic navigation system has the advantage of less distal locking time and less radiation dose.

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“…Hoffmann ve ark. [22] da yaptıkları kadavra çalışmasında navigasyon eşliğinde yaptıkları intramedüller çivilerin floroskopi eşliğinde yapılan serbest el tekniğine göre ortalama 244 saniye daha kısa sürede ve radyasyona maruz kalmadan yapılabileceğini göster-mişlerdir. İntramedüller çivileme sırasındaki yaşanılan zorlukları aşabilmek için geliştirilen bu üç kilitleme tekniği ve iki kontrol yöntemi aynı zamanda cerrahın ve hastanın radyasyona maruz kalmasını önlemekte ve ameliyat süresini de kısaltmaktadır.…”

Section: Discussionunclassified

Distal locking techniques without fluoroscopy in intramedullar nailing

Aldemir¹

2014

Eklem Hastalik Cerrahisi

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Next generation distal locking for intramedullary nails using an electromagnetic X-ray-radiation-free real-time navigation system

Abstract: Therapeutic study, level II.

Cited by 34 publications

References 18 publications

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Electromagnetic Tracking in Medicine—A Review of Technology, Validation, and Applications

Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of femoral intramedullary nails

Distal locking techniques without fluoroscopy in intramedullar nailing

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