Video-augmented fluoroscopy for distal interlocking of intramedullary nails decreased radiation exposure and surgical time in a bovine cadaveric setting

Abstract

Background: We aimed to assess the feasibility of a video-augmented fluoroscopy (VAF) technique using a camera-augmented mobile C-arm (CamC) for distal interlocking of intramedullary nails.

Methods: Three surgeons performed distal interlocking on seven pairs of cadaveric bovine carpal bones using the VAF system and conventional fluoroscopy. We compared radiation exposure, procedure time, and drilling quality between the VAF system and conventional fluoroscopic guidance.

Results: Distal interlocking using VAF significantly reduced the number of fluoroscopic images compared with conventional fluoroscopy (P < 0.05). No significant difference in overall procedure time (P = 0.96) or drilling quality (P = 0.12) was detected. VAF demonstrated improvement in radiation exposure when used by a less experienced surgeon (P < 0.05).

Conclusion: VAF is a feasible technique for distal interlocking. Overlaid visualization of the osseous anatomy in relation to the surgical field of view appears to improve surgeons' perception of relevant structures and their spatial orientation for the use of surgical instruments.

Keywords: CamC; augmented reality; camera augmented mobile C-arm; distal interlocking; intramedullary nails; video-augmented fluoroscopy.