Accuracy in Screw Selection in a Cadaveric, Small-Bone Fracture Model

Jernigan, Edward W.; Honeycutt, P. Barrett; Patterson, J. Megan M.; Rummings, Wayne A.; Bynum, Donald K.; Draeger, Reid W.

doi:10.1016/j.jhsa.2018.04.011

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…In an ex vivo study of human phalanges, screws were considered optimal in length in only 49.2% of instances. Screws were long in 41.5% and short in 9.3% of instances 15 . In that study, the likelihood of selecting a short screw was lower in observers with more surgical experience.…”

Section: Discussionmentioning

confidence: 62%

Evaluation of depth gauge accuracy in a canine tibial plateau leveling osteotomy model

McChesney¹,

Langenbach²,

Kruger³

et al. 2021

Veterinary Surgery

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Objective To evaluate the accuracy of six depth gauges used in three tibial plateau leveling osteotomy (TPLO) plate holes. Study design Ex vivo experimental study. Animals and sample population Cadaveric canine limbs (n = 10), one 25‐mm‐thick wood board, and one 33.8‐mm‐diameter polyvinyl chloride (PVC) pipe. Methods A TPLO was performed on 10 canine cadaveric pelvic limbs. Three 3.5‐mm plate holes were filled with screws. The remaining three plate holes: a compression hole, a combination compression‐locking hole, and a stacked combination compression‐locking hole were measured by three observers using six commercial depth gauges and using a micrometer as gold standard. The process was repeated on one wood board and one PVC pipe. Results Bone measurements collected using two depth gauges with base diameter < 5 mm were smaller than measurements collected using the four depth gauges with base diameter > 5.5 mm (p ranging from < .001 to .038). Mean depth gauge measurements were smaller than micrometer measurements by 2.20 mm for the compression hole, 0.82 mm for the combination hole, and 3.57 mm for the stacked combination hole. Measurement differences among depth gauges were also present for wood board and PVC pipe measurements. Bone measurement variability between depth gauges was less for the combination and compression holes than for the stacked combination hole. Conclusion Depth gauges lacked accuracy. Measurements differed among gauges and measurement variability varied based on plate hole geometry. Clinical relevance Depth gauge measurement accuracy varies based on measuring devices and on 3.5‐mm plate hole geometry.

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Section: Discussionmentioning

confidence: 62%

Evaluation of depth gauge accuracy in a canine tibial plateau leveling osteotomy model

McChesney¹,

Langenbach²,

Kruger³

et al. 2021

Veterinary Surgery

View full text Add to dashboard Cite

show abstract

“…Using a cadaveric model that simulates ORIF of proximal phalangeal fractures, Jernigan et al ( 20 ) measured drilled holes using a depth gauge without fluoroscopy assistance and studied the relationship between the level of training and the rates of ideal screw length selection among the surgeons. Ideal screws were defined as a screw that reached the volar cortex but did not protrude more than 1 mm beyond it and the study results showed that for 18 participants and a total of 648 selected screws, there was no relationship between the rate of ideal screw selection and level of training.…”

Section: Discussionmentioning

confidence: 99%

“…The most common error is an inaccurate measurement of the length of the drilled hole, subsequently leading to inaccurate screw choice. Using a cadaveric model that mimics clinical situations of ORIF of proximal phalangeal fractures, Jernigan et al ( 20 ) observed that most experienced surgeons were less likely to place short or excessively long screws. Besides, tactile feedback varies due to differences in cortical bone thickness and density at the metaphysis and diaphysis ( 21 ) resulting in measurement errors, which makes different passages of drilled holes another factor that influences measurement accuracy.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With the Accuracy of Depth Gauge Measurements

Liu

Xiao²,

Chen³

et al. 2022

Front. Surg.

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Background: It is important to select appropriate screws in orthopedic surgeries, as excessively long or too short a screw may results failure of the surgeries. This study explored factors that affect the accuracy of measurements in terms of the experience of the surgeons, passage of drilled holes and different depth gauges.Methods: Holes were drilled into fresh porcine femurs with skin in three passages, straight drilling through the metaphysis, straight drilling through the diaphysis, and angled drilling through the diaphysis. Surgeons with different surgical experiences measured the holes with the same depth gauge and using a vernier caliper as gold standard. The length of selected screws, and the time each surgeon spent were recorded. The measurement accuracy was compared based on the experiences of the surgeons and the passage of drilled holes. Further, parameters of depth gauges and 12-mm cortical bone screws from five different manufacturers were measured.Results: A total of 13 surgeons participated in 585 measurements in this study, and each surgeon completed 45 measurements. For the surgeons in the senior, intermediate, and junior groups, the average time spent in measurements was 689, 833, and 785 s with an accuracy of 57.0, 42.2, and 31.5%, respectively. The accuracy and measurement efficiency were significantly different among the groups of surgeons (P < 0.001). The accuracy of measurements was 45.1% for straight metaphyseal drilling, 43.6% for straight diaphyseal drilling, and 33.3% for angled diaphyseal drilling (P = 0.036). Parameters of depth gauges and screws varied among different manufacturers.Conclusion: Both observer factor and objective factors could affect the accuracy of depth gauge measurement. Increased surgeon's experience was associated with improvements in the accuracy rate and measurement efficiency of drilled holes based on the depth gauge. The accuracy rate varied with hole passages, being the lowest for angled drilled holes.

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Accuracy in Screw Selection in a Cadaveric, Small-Bone Fracture Model

Cited by 2 publications

References 14 publications

Evaluation of depth gauge accuracy in a canine tibial plateau leveling osteotomy model

Evaluation of depth gauge accuracy in a canine tibial plateau leveling osteotomy model

Factors Associated With the Accuracy of Depth Gauge Measurements

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