Definition of a measurement technique for hexapod circular smart fixators' perioperative assembly parameters and investigation of alignment and correlation with postoperative measurements: a retrospective cohort study.

Autor: Kanar M; Department of Orthopaedics and Traumatology, University of Health Sciences Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey. dr.kanar@hotmail.com., Sülek Y; Department of Orthopaedics and Traumatology, University of Health Sciences Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey., Seymenoğlu TH; Department of Orthopaedics and Traumatology, University of Health Sciences Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey., Armağan R; Department of Orthopaedics and Traumatology, University of Health Sciences Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Nov 20; Vol. 25 (1), pp. 933. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1186/s12891-024-08056-y
Abstrakt: Background: With the assistance of smart fixator technologies, the correction of complex deformities has been facilitated; however, the accurate integration of specialized radiographs and measurements into the system remains the greatest disadvantage, necessitating specialized imaging and an experienced team. When inexperienced technicians and doctors perform these specialized postoperative radiographs, excessive exposure of the patient and team to radioactive rays exacerbates inadequacies in measurements and delays the correction of residual deformities due to angular and translational adjustments. In this study, we compared postoperative measurements with those taken peroperatively via fluoroscopy, hypothesizing that it reduces the exposure of the patient and team to radioactive rays, allows for more accurate and timely correction of deformities and assembly parameters, and reduces time and costs.
Methods: Between 2013 and 2022, 84 patients with bone deformities were retrospectively reviewed. All patients had bone deformities and were treated with computer-assisted circular external fixator systems (Ca-CEF). Assembly parameter measurements began to be corrected via artificial neural network software via peroperative fluoroscopy in 37 patients and postoperative radiography in 47 patients. The surgical duration for all patients, peroperative measurement values, and number of radiographs taken on postoperative day 1, week, and month until deformity correction were recorded.
Results: The duration until deformity correction was shorter in patients who underwent postoperative measurements (mean 50.24 days) than in those who underwent peroperative measurements (mean 42.31 days), but this difference was not statistically significant (p = 0.102). The surgical duration was significantly shorter in patients with postoperative measurements (mean of 130.37 min) than in those with peroperative measurements (mean of 155.88 min) (p = 0.045). For patients with postoperative measurements, 56.04 postoperative radiographs were taken. In contrast, patients with peroperative measurements had fewer radiographs totaling 28.7. This difference was statistically significant (p < 0.01). There was no statistically significant difference in the fluoroscopy dose between patients with postoperative measurements (mean 18.54 mGy) and those with peroperative measurements (mean 22.22 mGy) (p = 0.105).
Conclusion: To achieve accurate assembly parameters, minimizing X-ray exposure is crucial but can pose challenges. Our results showed that despite an average increase of 25 min in surgical duration, the time taken for deformity correction was shorter. Additionally, we obtained fewer postoperative radiographs, indicating reduced radiation exposure.
Competing Interests: Declarations Ethics approval and consent to participate This study was initiated after the approval of University of Health Sciences Şişli Hamidiye Etfal Education and Research Hospital Health Practice and Research Center Clinical Research Ethics Committee dated 13.12.2022 and numbered 3740. Consent for publication Prior to the study, all participants signed an informed consent form agreeing to the publication of the information/images in this research. The subject of the images signed the consent form agreeing to publication in an online open-access journal. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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