Abstract
In minimally invasive bone fracture reduction surgery, broken femur bones are firmly fixed to a metallic intramedullary nail (IMN) after they are properly aligned. One of the greatest challenges of this process is that surgeons cannot directly see holes on the IMN, which increases the difficulty of the procedure and results in the requirement of taking a large number of X-ray images to find the location and direction of holes. We propose a novel distal interlocking screw guidance system that consists of a parallel guidance system using a laser pointer (PGSLP) and a mechanical fine-adjustment device (FAD). The PGSLP is used to make the planes of the C-arm and FAD parallel. The FAD is used to concentrically align the IMN hole with the guiding hole. The performance of the proposed device was evaluated by a series of experiments. The tilted angle error between the C-arm and FAD was measured to be 1.24 ± 0.715°. The translational error between the IMN hole and guiding hole was measured to be 0.378 ± 0.120 mm. Since the proposed guiding system is simple, cost-effective, and accurate, we expect it will soon be used in real operations.
Highlights
Since the intramedullary nailing treatment was first developed by Gerhard Kuntscher in 1940 [1], closed intramedullary nailing has become the most common treatment for fracture reduction surgery [2], which is performed with minimal opening of the tissue
This study proposed a novel interlocking screw guidance system that enables costeffective and accurate drill guidance for distal screwing procedures of a femur fracture reduction surgery
A lot of X-ray images are required in finding the direction and position of the hole, and our guidance process was divided into a parallelization step and a fine-positioning step
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. When a long bone, such as a femur, is broken, a fracture reduction surgery is performed to align the broken fractures and to fix them to a metallic member. Since the intramedullary nailing treatment was first developed by Gerhard Kuntscher in 1940 [1], closed intramedullary nailing has become the most common treatment for fracture reduction surgery [2], which is performed with minimal opening of the tissue. A thin guide wire is inserted into the fractured bone.
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