A Novel 3D-Printed Device for Precise Percutaneous Placement of Cannulated Compression Screws in Human Femoral Neck Fractures

Long, Cheng; Liu, Jinhai; Chai, Xiangping; Liu, Xiangfeng; Duan, Zhixi

doi:10.1155/2021/1308805

Cited by 8 publications

(22 citation statements)

References 21 publications

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“…An alternative is to use patient-specific drilling guides to translate the planned screw trajectories towards the actual surgery. It has been shown that this permits more accurate and efficient reductions compared with the freehand technique (Schweizer et al, 2016;Merema et al, 2017;IJpma et al, 2021;Long et al, 2021;Nasr et al, 2021).…”

Section: Intra-operative Navigationmentioning

confidence: 99%

“…16 studies reported on operation time (Li et al, 2015(Li et al, , 2019Zhang et al, 2015;Liu et al, 2017;Chen et al, 2018Chen et al, , 2019Chen et al, , 2020Hung et al, 2019;Huang et al, 2020;Wang et al, 2020cWang et al, , 2020aBoudissa et al, 2021aBoudissa et al, , 2021bLong et al, 2021;He et al, 2022;Zheng et al, 2022). All studies, except for , found that using computer-assisted planning leads to a significantly shorter operation time compared to conventional planning.…”

Section: Operation Timementioning

confidence: 99%

“…15 studies reported on intra-operative blood loss (Li et al, 2015(Li et al, , 2019Zhang et al, 2015;Chen et al, 2018Chen et al, , 2019Chen et al, , 2020Hung et al, 2019;Huang et al, 2020;Wang et al, 2020cWang et al, , 2020aBoudissa et al, 2021aBoudissa et al, , 2021bLong et al, 2021;He et al, 2022;Zheng et al, 2022) and all studies except for Li et al (2019) found that using VSP leads to significantly less blood loss. Boudissa et al (2021a) and Wang et al (2020b) did report that they found significant differences in blood loss using student t-tests and Mann-Whitney tests respectively, while the 95% CI intervals computed in this review using Review Manager failed to replicate these results, probably because of different test assumptions (see Figure 4B).…”

Section: Blood Lossmentioning

confidence: 99%

“…All studies that investigated fluoroscopy frequency (Liu et al, 2017;Chen et al, 2018Chen et al, , 2020Huang et al, 2020;Wang et al, 2020c;Long et al, 2021;He et al, 2022) found that using VSP leads to significantly less intra-operative fluoroscopies. The meta-analysis resulted in an overall standardized mean difference of -2.18 (95% CI: -2.75, -1.61), see Figure 4C.…”

Section: Fluoroscopy Frequencymentioning

confidence: 99%

“…15 studies reported on reduction quality (Li et al, 2015(Li et al, , 2019Liu et al, 2017;Maini et al, 2018;Totoki et al, 2018;Chen et al, 2019;Hung et al, 2019;Yoshii et al, 2019b;Huang et al, 2020;Ramanathan et al, 2020;Wang et al, 2020a;Boudissa et al, 2021aBoudissa et al, , 2021bLong et al, 2021;Zheng et al, 2022), using different scoring systems, including the Matta scoring system (Matta and Tornetta, 1996), residual displacement (mm) and/or level of alignment compared to the healthy contralateral side. 12 studies reported on functional clinical scores (Li et al, 2015;Liu et al, 2017;Chen et al, 2018Chen et al, , 2019Chen et al, , 2020Huang et al, 2020;Jia et al, 2020;Ramanathan et al, 2020;Wang et al, 2020c;Long et al, 2021;He et al, 2022;Zheng et al, 2022) using scoring systems such as the VAS score, Harris score, Merle d'Aubigne score and range of motion (ROM). Since the reported reduction and functional scores are highly heterogeneous between studies or not clearly specified, no meta-analysis was performed on these outcome measures.…”

Section: Reduction Quality and Functional Scoresmentioning

confidence: 99%

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Computer-Assisted Preoperative Planning of Bone Fracture Fixation Surgery: A State-Of-The-Art Review

Moolenaar¹,

Tümer²,

Checa³

2022

Preprint

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Background Bone fracture fixation surgery is one of the most commonly performed surgical procedures in the orthopedic field. However, fracture healing complications occur frequently, and the choice of the most optimal surgical approach often remains challenging. In the last years, computational tools have been developed with the aim to assist preoperative planning procedures of bone fracture fixation surgery. Objectives The aims of this review are (1) to provide a comprehensive overview of the state-of-the-art in computer-assisted preoperative planning of bone fracture fixation surgery, (2) to assess the clinical feasibility of the existing virtual planning approaches, and (3) to assess their clinical efficacy in terms of clinical outcomes as compared to conventional planning methods. Methods A literature search was performed in the MEDLINE-PubMed, Ovid-EMBASE, Ovid-EMCARE, Web of Science, and Cochrane libraries to identify articles reporting on the clinical use of computer-assisted preoperative planning of bone fracture fixation. Results 79 articles were included to provide an overview of the state-of-the art in virtual planning. While patient-specific geometrical model construction, virtual bone fracture reduction, and virtual fixation planning are routinely applied in virtual planning, biomechanical analysis is rarely included in the planning framework. 21 of the included studies were used to assess the feasibility and efficacy of computer-assisted planning methods. The reported total mean planning duration ranged from 22 to 258 minutes in different studies. Computer-assisted planning resulted in reduced operation time (Standardized Mean Difference (SMD): -2.19; 95% Confidence Interval (CI): -2.87, -1.50), less blood loss (SMD: -1.99; 95% CI: -2.75, -1.24), decreased frequency of fluoroscopy (SMD: -2.18; 95% CI: -2.74, -1.61), shortened fracture healing times (SMD:-0.51; 95% CI: -0.97, -0.05) and less postoperative complications (Risk Ratio (RR): 0.64, 95% CI: 0.46, 0.90). No significant differences were found in hospitalization duration. Some studies reported improvements in reduction quality and functional outcomes but these results were not pooled for meta-analysis, since the reported outcome measures were too heterogeneous. Conclusions Current computer-assisted planning approaches are feasible to be used in clinical practice and have been shown to improve clinical outcomes. Including biomechanical analysis into the framework has the potential to further improve clinical outcome.

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Section: Intra-operative Navigationmentioning

confidence: 99%

Section: Operation Timementioning

confidence: 99%

Section: Blood Lossmentioning

confidence: 99%

Section: Fluoroscopy Frequencymentioning

confidence: 99%

Section: Reduction Quality and Functional Scoresmentioning

confidence: 99%

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Computer-Assisted Preoperative Planning of Bone Fracture Fixation Surgery: A State-Of-The-Art Review

Moolenaar¹,

Tümer²,

Checa³

2022

Preprint

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Progress in clinical application of computer-assisted orthopedic surgery

Shen¹,

Liu²

2023

Digit Med

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With the rapid development of computer technology, new materials, 5G communication, artificial intelligence and robot technology, computer-assisted orthopaedic surgery (CAOS) technology has obtained an unprecedented opportunity for development, which has greatly promoted the personalized, accurate and minimally invasive process of orthopedic surgery. Compared with traditional orthopedic surgery, CAOS has significant advantages in implementing accurate surgery, shortening operation time, reducing patient trauma and reducing intraoperative X-ray radiation exposure. However, with the increasing medical needs of patients and the increasing medical costs, the technology of computer-assisted orthopedic surgery still needs to be improved. This paper mainly summarizes the current situation of clinical application of computer-assisted orthopedic surgery, focusing on following four aspects: broken bone splicing and restoration technology, 3D printing guide plate assisted orthopedic surgery, computer-assisted navigation in orthopedic surgery and orthopedic surgery robot technology. At the same time, the problems and difficulties existing in CAOS are discussed, and the author's own views on the future development of computer-assisted orthopedic surgery are put forward.

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A Novel Navigation Device for Precise Percutaneous Placement of the Guidewire in Femoral Neck Fracture Cannulated Screw Fixation Surgery

Cui,

Ren,

Peng

et al. 2024

IEEE J. Transl. Eng. Health Med.

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The accuracy of screw placement is a key factor for the stability of the cannulated screws used in the fixation of femoral neck fractures. In this study we designed a navigation device for ensuring the screw reaches the ideal position for optimal fixation. From March 2019 to September 2020, 66 patients with femoral neck fracture were enrolled and divided into 2 groups, one group was treated using the traditional free-hand cannulated screw fixation and the other using the new navigation device with assisted fixation. The effectiveness of the 2 methods was compared based on surgery duration, intraoperative bleeding, number of fluoroscopic examination and guidewire insertion attempts, screw parallelism, and effective fixation area. Fracture healing, complications and hip joint function were assessed after operation. The new navigation device reduced the duration of surgery without causing additional intraoperative bleeding, and significantly reduced number of fluoroscopy examination and guidewire insertion attempts (4.00±1.58 vs. 6.09±1.94 with traditional surgery). The accuracy of screw implantation was improved, as demonstrated by increased screw parallelism (0.71±0.57° vs. 1.66 ±1.01° with traditional surgery) and higher effective fixed area (64.88±10.52 vs. 58.61±9.19 mm2 with traditional surgery). In the postoperative follow-up, except for one case of femoral head necrosis and one case of bone nonunion in the traditional surgical group, the other patients showed fracture healing. There was no significant difference in hip joint function between the 2 groups. The new navigation device enables rapid and accurate guidewire positioning for cannulated screw fixation through simple operation procedures, resulting in good prospect for clinical transformation.

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A Novel 3D-Printed Device for Precise Percutaneous Placement of Cannulated Compression Screws in Human Femoral Neck Fractures

Cited by 8 publications

References 21 publications

Computer-Assisted Preoperative Planning of Bone Fracture Fixation Surgery: A State-Of-The-Art Review

Computer-Assisted Preoperative Planning of Bone Fracture Fixation Surgery: A State-Of-The-Art Review

Progress in clinical application of computer-assisted orthopedic surgery

A Novel Navigation Device for Precise Percutaneous Placement of the Guidewire in Femoral Neck Fracture Cannulated Screw Fixation Surgery

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