Training Femoral Neck Screw Insertion Skills to Surgical Trainees

Nousiainen, Markku; Omoto, Daniel; Zingg, Patrick O.; Weil, Yoram A.; Mardam-Bey, Sami W.; Eward, William C.

doi:10.1097/bot.0b013e3182604b49

Cited by 20 publications

(10 citation statements)

References 20 publications

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“…More recent literatures [ 22 , 23 ] have shown the simultaneously expanded feedback offered by the newer technology is likely to be an useful tool to teach surgical techniques and doesn’t do harm to learning. Basing on this presupposition, Leroux et al [ 24 ] conduct a trial to make a comparison on what will the fluoroscopy or electromagnetic (EM) guidance bring to the surgical new hands’ studying about the locking of inserting screw in tibial nails.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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BackgroundIt is challenges for surgeon to position the distal locking screw of a tibia intramedullary nail. The traditional free-hand (FH) technique is related to the proficiency of surgeons and has a long learning curve. Furthermore, the radiation dose and the accuracy of screw placement should be taken into account. The new technology, the electromagnetic navigation system (ET), which is a radiation-free way to locate the position of the drill bit. The purpose of our study is to evaluate the results of the ET for distal locking screw of a tibia intramedullary nail and to compare the effects with the FH technique.MethodsEighty-nine cases of tibia diaphyseal fracture who needed to treat by intramedullary nails were analyzed retrospectively, and were divided into 2 groups. Patients in navigation group (n = 54) were treated with intramedullary nail using the ET for distal locking, while other 35 patients using FH technique. Intraoperative fluoroscopy exposure times, screw insertion times, and healing times were recorded. The parameter was used for comparison in 2 groups.ResultsThe mean time of distal locking in the ET technique was significant less than that in the FH group (5.89 ± 2.02 minutes vs 12.26 ± 4.40 minutes) and the exposure time was reduced in ET group significantly (2.13 ± 0.73 seconds vs 19.09 ± 10.41 seconds). The healing time was proved to be coincident in FH group and ET group (15.34 ± 2.98w vs 16.06 ± 3.74w). The one-time success rate of distal locking nail operation was 100% in the navigation group, which was significantly higher than that in FH group (P < .05).ConclusionCompared with the FH technique, the ET for distal locking of tibia intramedullary nail has the advantages of high efficiency and short locking time without radiation.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…It is believed to have the potential to improve the precision of guidewire insertion. However, previous studies demonstrated that the navigation system increases the radiation and operative time [15–19]. Additionally, the navigation system is expensive and complicated.…”

Section: Discussionmentioning

confidence: 99%

A Novel Guidewire Aiming Device to Improve the Accuracy of Guidewire Insertion in Femoral Neck Fracture Surgery Using Cannulated Screw Fixation

Yin

et al. 2016

Med Sci Monit

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BackgroundThe aim of this study was to improve the accuracy of guidewire insertion in the femoral neck fracture surgery using cannulated screw fixation.Material/MethodsA novel aiming device was designed and manufactured. Between January 2010 and June 2012, 64 femoral neck fracture patients were included into the study. All 64 patients were divided into 2 groups randomly. The aiming device was used during the operation for patients in the experimental group, but not in the control group.ResultsThere were no statistically significant differences in operative time or bleed volume between the groups (P>0.05). The frequency of guidewire drilling was significantly lower in the experimental group than in the control group (P<0.05). The angle between the first cannulated screw and the central axis of the femoral neck in coronal plane and sagittal plane, and the distance between the bottom cannulated screw and the medial calcar femorale rim, were significantly smaller in the experimental group than in the control group (P<0.05).ConclusionsThe aiming device is simple in structure and easy to use. It could help surgeons to accurately insert cannulated screw guidewires. The aiming device is suitable for broad clinical use.

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“…10 Computer navigation, which provides concurrent augmented feedback during surgery, has been advocated to be an important surgical training tool in arthroplasty, and potentially in hip fracture surgery as well. 11, 12, 13 Participants who trained with computer navigation took fewer attempts to position screws in the hip and used less fluoroscopy time than those trained with fluoroscopy. 11 …”

Section: Discussionmentioning

confidence: 99%

“…11, 12, 13 Participants who trained with computer navigation took fewer attempts to position screws in the hip and used less fluoroscopy time than those trained with fluoroscopy. 11 …”

Section: Discussionmentioning

confidence: 99%

A Hybrid Reality Radiation-Free Simulator for Teaching Wire Navigation Skills

Kho

Johns

Thomas

et al. 2015

Journal of Orthopaedic Trauma

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Objectives Surgical simulation is an increasingly important method to facilitate the acquiring of surgical skills. Simulation can be helpful in developing hip fracture fixation skills because it is a common procedure for which performance can be objectively assessed (i.e., the tip-apex distance). The procedure requires fluoroscopic guidance to drill a wire along an osseous trajectory to a precise position within bone. The objective of this study was to assess the construct validity for a novel radiation-free simulator designed to teach wire navigation skills in hip fracture fixation. Methods Novices (N=30) with limited to no surgical experience in hip fracture fixation and experienced surgeons (N=10) participated. Participants drilled a guide wire in the center-center position of a synthetic femoral head in a hip fracture simulator, using electromagnetic sensors to track the guide wire position. Sensor data were gathered to generate fluoroscopic-like images of the hip and guide wire. Simulator performance of novice and experienced participants was compared to measure construct validity. Results The simulator was able to discriminate the accuracy in guide wire position between novices and experienced surgeons. Experienced surgeons achieved a more accurate tip-apex distance than novices (13 vs 23 mm, respectively, p=0.009). The magnitude of improvement on successive simulator attempts was dependent on level of expertise; tip-apex distance improved significantly in the novice group, while it was unchanged in the experienced group. Conclusions This hybrid reality, radiation-free hip fracture simulator, which combines real-world objects with computer-generated imagery demonstrates construct validity by distinguishing the performance of novices and experienced surgeons. There is a differential effect depending on level of experience, and it could be used as an effective training tool in novice surgeons.

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Training Femoral Neck Screw Insertion Skills to Surgical Trainees

Abstract: The findings of this study suggest that computer navigation may be safely used to train surgical novices in a basic procedure. This model avoids using both live patients and harmful radiation without a compromise in the acquisition of a 3-dimensional technical skill.

Cited by 20 publications

References 20 publications

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

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

A Novel Guidewire Aiming Device to Improve the Accuracy of Guidewire Insertion in Femoral Neck Fracture Surgery Using Cannulated Screw Fixation

A Hybrid Reality Radiation-Free Simulator for Teaching Wire Navigation Skills

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