Patient-specific Guides Improve the Accuracy and Safety of Transcondylar Screw Placement-a Cadaveric Study in the Canine Humerus.

IF 1 2区农林科学 Q3 VETERINARY SCIENCES

Veterinary and Comparative Orthopaedics and Traumatology Pub Date : 2025-02-11 DOI:10.1055/a-2510-3720

Joshua T Kershaw, Bill Oxley, Matthew J Allen

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引用次数: 0

Abstract

Objectives: The goal of this study was to compare the accuracy and safety of a transcondylar screw (TCS) placed using a 3D-printed patient-specific guide (PSG) or a generic aiming device (AD). We hypothesized that PSG is more accurate (i.e., positioning and orientation closer to the optimal trajectory) and safer (reduced incidence of joint violation) than the AD.

Methods: A total of seven pairs of forelimbs were allocated to PSG and AD groups. After CT scanning, the optimal TCS orientation was planned in silico by a surgical specialist, and guides were printed. Using the PSG or AD, a 2.5-mm drill hole was drilled from medial to lateral across the humeral condyle. The positioning of the "planned" and "achieved" drill holes was defined on postoperative CT. The accuracy of TCS positioning and the risk of joint penetration were then calculated for the two groups.

Results: Positioning of the entry and exit holes was significantly more accurate in the PSG group. Differences in screw angulation were not significantly different between groups. Despite the presence of an outlier (caused by incomplete seating of the PSG against the bone), 7 out of 7 screws positioned with PSG were "safe," while 3 out of 7 from the AD group would have violated the joint.

Conclusion: Our data confirm the technical superiority of PSG over the AD for placement of a TCS in the humeral condyle.

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患者特异性指南提高经髁螺钉置入的准确性和安全性——犬肱骨的尸体研究。

目的：本研究的目的是比较使用3d打印的患者专用指南（PSG）或通用瞄准装置（AD）放置经髁螺钉（TCS）的准确性和安全性。我们假设PSG比AD更准确（即定位和方向更接近最佳轨迹）和更安全（减少关节侵犯的发生率）。方法：将7对前肢分为PSG组和AD组。CT扫描后，由外科专家在计算机上规划最佳TCS定位，并打印指南。使用PSG或AD，从内侧到外侧穿过肱骨髁钻一个2.5 mm的钻孔。术后CT确定“计划”钻孔和“完成”钻孔的定位。然后计算两组TCS定位的准确性和关节穿透的风险。结果：PSG组入、出孔定位精度明显提高。各组间螺钉成角差异无统计学意义。尽管存在异常值（由于PSG未完全固定在骨头上），但7个定位PSG的螺钉中有7个是“安全的”，而AD组的7个螺钉中有3个会破坏关节。结论：我们的数据证实了PSG在肱骨髁上放置TCS的技术优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Veterinary and Comparative Orthopaedics and Traumatology 农林科学-动物学

CiteScore

2.00

自引率

15.40%

发文量

审稿时长

18-36 weeks

期刊介绍： Veterinary and Comparative Orthopaedics and Traumatology (VCOT) is the most important single source for clinically relevant information in orthopaedics and neurosurgery available anywhere in the world today. It is unique in that it is truly comparative and there is an unrivalled mix of review articles and basic science amid the information that is immediately clinically relevant in veterinary surgery today.