Kirschner wire placement in scaphoid bones using fluoroscopic navigation: a cadaver study comparing conventional techniques with navigation.
BACKGROUND
During scaphoid fixation, a pin guide is first inserted along the axis of the scaphoid, and then a cannulated screw is inserted around the pin guide. At least, the pinguide is removed. To verify the position of the pin guide, fluoroscopy is typically used, with the disadvantage of irradiation. Thus, it is impossible to visualize the pin guide in more than one view simultaneously. The goal of this study was to compare two pin guide placement techniques in scaphoid fixation: conventional (CF) vs. fluoroscopic navigation (FN).


METHODS
Eleven upper limbs of cadavers were divided into two groups. The CF group included four scaphoids which were to be fixed with pin guide. The FN group included seven scaphoids which were to be fixed with the same technique under FN.


RESULTS
The accuracy of screw insertion in both groups does not differ. In the CF group, the X-ray exposure time is four times higher. The total duration of the surgical procedure is slightly higher in the FN group.


CONCLUSIONS
We are of the opinion that FN could be applied in clinical practice and could offer significant benefits in the treatment of fixation of the scaphoid.
Liverneaux
Philippe A
PA
Department of Hand Surgery, Strasbourg University Hospital, 10 Avenue Baumann, F-67403 Illkirch cedex, France. p.liverneaux@wanadoo.fr
Gherissi
Anes
A
Stefanelli
Matthieu Beustes
MB
D001858:Bone Nails; D001864:Bone Wires; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D016268:Internal Fixators; D021361:Scaphoid Bone / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*