Additional Visualization via Smart Glasses Improves Accuracy of Wire Insertion in Fracture Surgery

Abstract

Smart glasses (SG) are a wearable device consisting of a small computer built into a head-mounted monitor (HMM) that can display various kinds of information. Lateral side visualization is displayed on the HMM of SG so the operator may also see it and the anteroposterior (AP) direction simultaneously. The present pilot study aimed to investigate the usefulness of SG in wire insertion for bone fracture. We marked both the front and lateral sides of the shaft of an artificial femur bone. From the tip of the greater trochanter, we inserted a 2.4-mm Kirschner wire (K-wire) so that it could be directed toward the marks in both planes. Three surgeons enrolled in the study each performed 10 trials, both with SG (SG arm) and without (direct vision arm). We defined the error angle as the angle between the K-wire and the line connecting the marking point from the insertion point in both the front and lateral view images. We also measured the time it took to insert the K-wire in both arms. The SG had a significantly reduced (mean = 3.2°) error angle ( P = .02) when compared to the direct vision group (mean = 4.8°). However, no significant difference was found between direct vision (mean = 17.5 seconds) and SG arms (mean = 14.9 seconds) in the insertion time. While keeping the AP image view in primary focus, simultaneously viewing the lateral side of the surgical field using SG helps achieve more accurate wire insertion in surgery.