Dataset Information

C-Arm Image-Based Surgical Path Planning Method for Distal Locking of Intramedullary Nails.

ABSTRACT: Due to the curvature of the bone marrow cavity, the intramedullary nail used in long bone fracture fixation can be deformed, causing displacement of the locking holes. In this study, an algorithm using only one C-arm image to determine the center positions and axial directions of locking holes was developed for drilling guidance. Based on conventional method that the axial direction of locking hole would be identified when locking hole contour is presented as a circle, the proposed method can locate the circle contour centroid by using one C-arm image including two elliptical contours. Then the two distal locking holes' axial direction and centers would be determined. Three experiments were conducted to verify the performance of the proposed algorithm, which are (1) computer simulation, (2) use of real intramedullary nails, and (3) actual drilling test with the bone model. The experimental results showed that the average error of the axial direction and center position were 0.62?±?0.6°, 0.73?±?0.53?mm (simulation) and 3.16?±?1.36°, 1.10?±?0.50?mm (actual nail), respectively. The last ten drilling test sets were completed successfully (with an average duration of 48 seconds). Based on the experimental results, the proposed algorithm was feasible for clinic applications.

SUBMITTER: Hsu WE

PROVIDER: S-EPMC5989302 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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C-Arm Image-Based Surgical Path Planning Method for Distal Locking of Intramedullary Nails.

Hsu Wei-En WE Yu Ching-Hsiao CH Chang Chih-Ju CJ Wu Hung-Kang HK Yu Tsong-Han TH Tseng Ching-Shiow CS

Applied bionics and biomechanics 20180523

Due to the curvature of the bone marrow cavity, the intramedullary nail used in long bone fracture fixation can be deformed, causing displacement of the locking holes. In this study, an algorithm using only one C-arm image to determine the center positions and axial directions of locking holes was developed for drilling guidance. Based on conventional method that the axial direction of locking hole would be identified when locking hole contour is presented as a circle, the proposed method can lo ...[more]

PMID: 29951112

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Project description:OBJECTIVES:This feasibility study and process evaluation assessed the likely success of a definitive trial of intramedullary fixation with locked retrograde nails versus extramedullary fixation with fixed angle plates for fractures of the distal femur. DESIGN & SETTING:A multicentre, parallel, two-arm, randomised controlled feasibility study with an embedded process evaluation was conducted at seven NHS hospitals in England. Treatment was randomly allocated in 1:1 ratio, stratified by centre and chronic cognitive impairment. Participants, but not surgeons or research staff, were blinded to the allocation. PARTICIPANTS:Patients 18 years and older with a fracture of the distal femur, who their surgeon believed would benefit from internal fixation, were eligible to take part.Participants were allocated to receive either a retrograde intramedullary nail or an anatomical locking plate. OUTCOMES:The primary outcomes for this feasibility study were the recruitment rate and completion rate of the EQ-5D-5L at 4?months post-randomisation. Baseline characteristics, disability rating index, quality of life scores, measurements of social support and self-efficacy, resource use and radiographic assessments were also collected. The views of patients and staff were collected during interviews. RESULTS:Recruitment and data completion were lower than expected. 23 of 82 eligible patients were recruited (nail, 11; plate, 12). The recruitment rate was estimated as 0.42 (95% CI 0.27 to 0.62) participants per centre-month. Data completeness of the EQ-5D-5L at 4?months was 61 per cent (95%?CI 43% to 83%). The process evaluation demonstrated that the main barriers to recruitment were variation in treatment pathways across centres, lack of surgeon equipoise and confidence in using both interventions and newly formed research cultures that lacked cohesion. CONCLUSIONS:A modified trial design, with embedded recruitment support intervention, comparing functional outcome in cognitively intact adults who have sustained a fragility fracture of the distal femur is feasible. ETHICS APPROVAL:The Wales Research Ethics Committee 5 approved the study (ref: 16/WA/0225). TRIAL REGISTRATION NUMBER:ISRCTN92089567; Pre-results.

Dataset Information

C-Arm Image-Based Surgical Path Planning Method for Distal Locking of Intramedullary Nails.

Publications

C-Arm Image-Based Surgical Path Planning Method for Distal Locking of Intramedullary Nails.

Similar Datasets

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