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Kirschner wire placement in scaphoid bones using intraoperative CT-guided stereotaxy.
MedLine Citation:
PMID:  23033958     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract 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:
Christian Niederwanger; Gerlig Widmann; Martin Knoflach; Peter Schullian; Romed Hoermann; Reto Bale
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-4
Journal Detail:
Title:  Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy     Volume:  -     ISSN:  1365-2931     ISO Abbreviation:  Minim Invasive Ther Allied Technol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612996     Medline TA:  Minim Invasive Ther Allied Technol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Section of Microinvasive Therapy, Department of Radiology, Innsbruck Medical University , Innsbruck , Austria.
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