Image intensifier distortion influences a surgeon's ability to aim guidewires during orthopaedic procedures

Skeletal Radiology
Thomas R WardPaul N Smith

Abstract

Accurate insertion of a guidewire under image intensifier guidance is a fundamental skill required by orthopaedic surgeons. This study investigated how image intensifier distortion, which is composed of pin-cushion and sigmoidal components, changed the apparent trajectory of a guidewire, and the resulting deviation between the intended and actual guidewire tip position. Intraoperative image intensifier images for 220 consecutive patients with hip fractures were retrospectively corrected for distortion using a global polynomial method. The deviation between the intended and actual guidewire tip positions was calculated. Additional distortion parameters were tested using an image intensifier produced by a different manufacturer, and a flat-panel c-arm. Deviation was approximately 1 cm if the guidewire was aimed from the extremity of the image and almost 0 if the entry point was only 20% from the centre (p < 0.001). The direction of deviation was different for left and right hips, with average deviations measuring 3 mm proximal and 5 mm distal respectively (p < 0.001). The flat-panel c-arm almost completely eliminated distortion. Image intensifier distortion significantly altered the intended trajectory of a guidewire, with guidew...Continue Reading

References

Jan 1, 1981·Journal of Biomechanics·W A Wallace, F Johnson
Oct 26, 2005·Journal of Orthopaedic Trauma·D MaymanD R Pichora
Jul 1, 2006·BMJ : British Medical Journal·Martyn Parker, Antony Johansen
Feb 23, 2010·International Orthopaedics·Kristian BjorgulKhaled J Saleh
Mar 19, 2011·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Edward Lee Nickoloff
Jun 29, 2011·Journal of Surgical Education·John M FroelichD Gordon Allan
Feb 24, 2012·International Orthopaedics·Marcus Christian MüllerOliver Weber
Sep 18, 2014·Acta orthopaedica et traumatologica turcica·Burak AltintasHermann Josef Bail

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Citations

Mar 20, 2021·BMC Musculoskeletal Disorders·Jan GessmannHinnerk Baecker

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