Skip to main content
SpringerLink
Log in

Investigating the performance of a wrist stabilization device for image-guided percutaneous scaphoid fixation

  • Original Article
  • Published:
International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose   

Conventional navigated surgery relies on placement of a reference marker on the anatomy of interest. However, placement of such a marker is not readily feasible in small anatomic regions such as the scaphoid bone of the wrist. This study aimed to develop an alternative mechanism for patient tracking that could be used to perform navigated percutaneous scaphoid fixation.

Methods   

A prototype wrist stabilization device was developed to immobilize the scaphoid relative to a reference marker attached to the device. A position measurement system and 3D fluoroscopy were used to study the accuracy and limitations of wrist stabilization during simulated clinical usage with a cadaver specimen. Reference markers mounted on the device were used to measure intra-device motion. Radiometallic beads implanted in the scaphoid were used to measure patient-device motion. Navigated planning and guidance of scaphoid fixation were performed in five cadaver and eight “ideally immobilized” plastic specimens. Postoperative 3D fluoroscopy was used to assess the accuracy of navigated drilling.

Results   

The average intra-device motion was 1.9 mm during load application, which was elastically recovered upon release of the load. Scaphoid motion relative to the reference marker was predominately rotational with an average displacement of 1.25 mm and \(2.0^{\circ }\). There was no significant difference in the accuracy of navigated drilling between the cadaver specimens and the ideally immobilized group.

Conclusions   

The prototype wrist stabilization device meets the criteria for effective wrist stabilization. This study provides insight concerning proper use of the device to minimize scaphoid displacement and design recommendations to improve immobilization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Langlotz F, Nolte L-P (2004) Technical approaches to computer-assisted orthopedic surgery. Eur J Trauma 30(1):1–11. doi:10.1007/s00068-004-1374-0

    Article  Google Scholar 

  2. Liverneaux PA, Gherissi A, Stefanelli MB (2008) Kirschner wire placement in scaphoid bones using fluoroscopic navigation: a cadaver study comparing conventional techniques with navigation. Int J Med Robot 4(2):165–173. doi:10.1002/rcs.194

    Article  PubMed  Google Scholar 

  3. Walsh E, Crisco JJ, Wolfe SW (2009) Computer-assisted navigation of volar percutaneous scaphoid placement. J Hand Surg Am 34(9):1722–1728. doi:10.1016/j.jhsa.2009.08.009

    Article  PubMed  Google Scholar 

  4. Niederwanger C, Wildmann G, Knoflach M, Schullian P, Hoermann R, Bale R (2012) Kirschner wire placement in scaphoid bones using intraoperative CT-guided stereotaxy. Minim Invasive Ther Allied Technol. (Epub ahead of print). doi:10.3109/13645706.2012.724688

  5. Citak M, O’Loughlin PF, Kendoff D, Suero EM, Gaulke R, Olivier LC, Krettek C, Hufner T (2010) Navigated scaphoid screw placement using customized scaphoid splint: an anatomical study. Arch Orthop Trauma Surg 130(7):889–895. doi:10.1007/s00402-010-1044-0

    Article  PubMed  Google Scholar 

  6. Smith EJ, Al-Sanawi HA, Gammon B, St John PJ, Pichora DR, Ellis RE (2012) Volume slicing of cone-beam computed tomography images for navigation of percutaneous scaphoid fixation. Int J Comput Assist Radiol Surg 7(3):433–444. doi:10.1007/s11548-011-0634-9

    Article  PubMed  Google Scholar 

  7. Smith EJ, Oentoro A, Al-Sanawi H, Gammon B, Pichora DR, Ellis RE (2010) Calibration and use of intraoperative cone-beam computed tomography: an in-vitro study for wrist fracture. Med Image Comput Comput Assist Interv 13(3):359–366

    Google Scholar 

  8. Horn BKP (1987) Closed-form solution of absolute orientation using unit quaternions. J Opt Soc Am A 4(4):629–642. doi:10.1364/JOSAA.4.000629

  9. Northern Digital Inc. (2006) Optotrak certus user guide. Revision 2. Northern Digital, Waterloo, Canada

  10. Wiles AD, Thompson DG, Frantz DD (2004) Accuracy assessment and interpretation for optical tracking systems. Proc SPIE Med Imaging Vis Image Guid Proced Disp 5367:421–432. doi:10.1117/12.536128

    Google Scholar 

  11. Smith R, Self M, Cheeseman P (1990) Estimating uncertain spatial relationships in robotics. In: Cox IJ, Wilfong IJ (eds) Autonomous robot vehicles, vol 4. Springer, New York, pp 167–193

    Chapter  Google Scholar 

Download references

Acknowledgments

The authors wish to acknowledge Mr. Paul St. John for provided software support for the navigation interface used in this study.

Conflict of Interest

None.

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, Queen’s University, Kingston, ON, Canada

    Erin J. Smith, Richard W. Sellens, Randy E. Ellis & David R. Pichora

  2. School of Computing, Queen’s University, Kingston, ON, Canada

    Gregory Allan & Randy E. Ellis

  3. Department of Surgery, Kingston General Hospital, Kingston, ON, Canada

    Braden Gammon, Randy E. Ellis & David R. Pichora

Authors
  1. Erin J. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregory Allan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Braden Gammon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Richard W. Sellens
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Randy E. Ellis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David R. Pichora
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Randy E. Ellis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, E.J., Allan, G., Gammon, B. et al. Investigating the performance of a wrist stabilization device for image-guided percutaneous scaphoid fixation. Int J CARS 9, 155–164 (2014). https://doi.org/10.1007/s11548-013-0834-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11548-013-0834-6

Keywords

Search

Navigation