A Novel Tracker-Less, Universal, Image-Based, Computer-Assisted Navigation in Orthopaedic Trauma- A pilot Study.

Abstract

Computer-assisted navigation system is well-known orthopaedic advancement which allow surgeon to obtain a real-time feedback during surgeries, thus helps to reduce intraoperative errors. Currently used navigation systems are tracker based, invasive and non-universal. Therefore this study was conducted to test novel tracker-less, image-based, non-invasive, universal, real-time navigation system to predict future position of the guide wire, K wire, screws and plates in orthopaedic trauma surgeries. Firstly, the software was tested and validated on bone model. Then utilized for non-randomised comparative study conducted on 81 adult patients with stable intertrochanteric fracture treated by dynamic hip screw and barrel plate fixation. In one group, C-arm was used and in other, software navigation was used in addition to C-arm. Parameters such as time to insertion, number of C-arm shoots and number of attempts for guide wire insertion were documented and compared. Use of the navigation software for guide wire positioning in bone models and in the DHS barrel plate surgery proved to be significantly beneficial as compared to not using navigation. Intraoperative use of this new navigation system eliminates trial and error improving accuracy and reducing the operative time and radiation exposure. Thus this novel trackerless, C-arm image-based navigation system have potential to replace existing tracker-based navigation systems because of its universal nature, noninvasive and more effective properties.