Navigated treatment of metatarsal V fractures using a new image based guidance system.
BACKGROUND
Computer assisted imaging systems are rarely used for fracture treatment and foot surgery. We introduce a new system for image based guidance in traumatology.


METHODS
We included 20 patients with a fracture of the fifth metatarsal. They were randomized on admission into two groups. Ten patients in the metatarsal group were operated conventionally and ten were operated with the assistance of a new image guidance system. This system is based on 2D-fluoro images which are acquired with a conventional c-arm and are transferred to the system workstation. After detecting marked tools, it can be used to display trajectories for K-wire guidance in the c-arm shot.


RESULTS
The average duration of surgery in the image-guided group was 12.7 minutes. In the conventional treated group, it was 17 minutes. The average duration of radiation was 18 seconds in the image-guided group vs. 32.4 seconds in the conventional group. 1.6 trials were necessary to position the K-wire for image-guided procedures in comparison to 2.7 trials in the conventional group.


CONCLUSIONS
Image-based guidance systems can be used for indications, were hitherto existing navigation systems are limited due to their dependence on fixed reference devices. Image-guided systems can be integrated into existing workflows and can reduce the malpositioning of guidewires.
Institute of Research in Rehabilitation Medicine at Ulm University, Wuhrstrasse 2/1, 88422, Bad Buchau, Germany. kraus@email.de
Michael
M
Kraus
Christoph
C
Dehner
Christoph
C
Riepl
Gert
G
Krischak
Florian
F
Gebhard
Hendrik
H
Schöll
D000328:Adult; D000368:Aged; D001864:Bone Wires; D005471:Fluoroscopy / Q000295:instrumentation; D018409:Foot Injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008682:Metatarsal Bones / Q000293:injuries* / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D019637:Orthopedic Procedures / Q000295:instrumentation; D011446:Prospective Studies; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D055815:Young Adult