HOW TO USE THE APP FOR DISTAL SCREW TARGETING IN INTRA MEDULLARY NAILING OF BONES скачать в хорошем качестве

HOW TO USE THE APP FOR DISTAL SCREW TARGETING IN INTRA MEDULLARY NAILING OF BONES

Intramedullary nailing is considered one of the most technically demanding procedures in orthopedic trauma surgery Using the free-hand technique, a varying number of x-ray images is necessary to locate the axes of the distal holes on the intramedullary nail depending on the surgeon’s skills. The ‘‘free-hand technique’’ is not sufficiently accurate, because it is conducted by repeated trials using two-dimensional fluoroscopic images. Determining the distal hole using fluoroscopy requires even more radiographic exposure. The greatest level of radiation exposure to the patient and operating room staff was recorded during intramedullary nailing that involves distal interlocking. Misplacement of distal interlocking screws can lead to iatrogenic fractures, instability of the bone-implant construct or even misalignment of the extremity; repeated drilling attempts can cause additional bony and soft tissue trauma In an attempt to reduce this potentially harmful radiation burden or misplacement , several authors proposed fluoroscopy-independent, proximally mounted target systems.  Numerous innovative techniques and devices have been proposed to simplify but have limitations radiation-independent nail-mounted targeting system, including hand-held targeting devices and radiolucent drill guides,[laser-guided systems, computer-assisted systems,[self-locking nailing systems.Each technique has its own advantages and disadvantages.Although these systems improve the operation accuracy, they still rely on radiographic images and or the costs of configuring these systems are high and cumbersome . Londei et al. proposed an augmented reality application that visually depicts to the surgeon two ‘augmented’ circles, their centers lying on the axis of the nail hole, making it visible in space. After an initial X-ray image acquisition, real-time video guidance using CamC allows the surgeon to superimpose the ‘augmented’ circles by moving the patient leg; the resulting X-ray showing nail holes appearing as circles. Following this, distal locking of the nail hole can be completed. In general, AR has not been widely accepted in clinical practice due to its cumbersome system setups, the requirement of a line-of-sight for tracking, on-site calibration, and a lack of real-time accurate registration between medical data The app might offer a robust guidance solution and has great potential to serve as a novel tool for intramedullary nailing for the unimpeded passage of the drill bit through the locking hole of a given nail. The app offers a method that is free of dedicated calibration for different types of nails Nails could be calibrated and the passive sensor deliberates the surgeon of cumbersome calibration procedures app which is independent from nail lengths before operation. The App is low-cost and offers accurate distal locking method in intramedullary nailing, without any radiation exposure. Augmented Reality Targeting App could be an appealing alternative for distal Locking of tibial intramedullary nails App offer a handy navigation system that allows orthopedic surgeons to achieve intramedullary nailing in a precise and time-saving way, with few fluoroscopic image acquisitions. more www.orthopractis.com https://apps.apple.com/gr/app/imnails... system can potentially reduce intraoperative time, reduce complications associated with malpositioning and fluoroscopy time exposure, allowing novice and expert surgeons alike to perform easily the distal locking. The app can be a novel tool for education and training young fellows or residents in orthopaedic surgery by practicing over a benchmark with saw bone before use in real surgery.