Computer Assisted Guided Placement of IMF Screws in Craniomaxillofacial Trauma: An Evolving Technique

FACE ◽  
2021 ◽  
pp. 273250162110086
Author(s):  
Joseph Kamal Muhammad
Keyword(s):  
Maxillofacial Surgery ◽  
Operation Time ◽  
Technical Note ◽  
Patient Specific ◽  
Computer Assisted ◽  
Intermaxillary Fixation ◽  
Surgical Guides ◽  
Craniomaxillofacial Trauma ◽  
Potential Benefits ◽  
Maxilla And Mandible

Intermaxillary fixation (IMF) screws have been introduced into maxillofacial trauma practice to reduce operation time and the complications associated with the placement of wire ligatures around teeth. Wires continue to be used to secure arch bars to teeth, form eyelets and long ligatures prior to putting a patient into maxillomandibular fixation (MMF). The application of wires to dental arches may result in sharp injuries to the operator, whereas injury to roots and nerves may arise from incorrect positioning of IMF screws in the jaws. The purpose of this technical note is to demonstrate how 3D patient specific (PS) surgical guides can be planned and fabricated to assist in the safe placement of IMF screws in the maxilla and mandible. It is proposed that PS IMF screw guides can be further developed to incorporate removable spoons and semi-circular access ports that not only facilitate safe screw placement but allow the guide to remain in position until all screw are secured. The potential benefits of PS IMF surgical guides include diminished risk of injury to facial structures and reduced operation time. The technique also lends itself to the placement of IMF screws via a robotic arm contributing to a safer operating environment for the maxillofacial surgery team.

scholarly journals Application of a new percutaneous multi-function pedicle locator in minimally invasive spine surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaojian Liu ◽  
Hairun Liu ◽  
Yushan Wang
Keyword(s):  
Minimally Invasive ◽  
Spine Surgery ◽  
Three Dimensional ◽  
Operation Time ◽  
Minimally Invasive Spine Surgery ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Number Of Patients ◽  
Potential Benefits ◽  
Minimally Invasive Spine

AbstractIn this study, a new percutaneous multi-function pedicle locator was designed for personalized three-dimensional positioning of a pedicle in minimally invasive spine surgery (MISS) without computer-assisted navigation technology. The proposed locator was used in a number of patients during MISS, and its advantages were analyzed. Based on the position of a pedicle determined by computed tomography (CT) and fluoroscopic images of a patient, 6 lines and 2 distances were used to determine the puncture point of a pedicle screw on skin, while 2 angles were used to indicate the direction of insertion of a pedicle guide needle from the patient's body surface. The results of the proposed locator were compared with those of the conventional freehand technique in MISS. The potential benefits of using the locator included enhanced surgical accuracy, reduced operation time, alleviation of the harmful intra-operative radiation exposure, lower costs, and shortened learning curve for young orthopedists.

scholarly journals Corrective Osteotomy of Upper Extremity Malunions Using Three-Dimensional Planning and Patient-Specific Surgical Guides: Recent Advances and Perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Babak Saravi ◽  
Gernot Lang ◽  
Rebecca Steger ◽  
Andreas Vollmer ◽  
Jörn Zwingmann
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Therapeutic Approach ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Current Evidence ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides ◽  
Recent Advances

Malunions of the upper extremity can result in severe functional problems and increase the risk of osteoarthritis. The surgical reconstruction of complex malunions can be technically challenging. Recent advances in computer-assisted orthopedic surgery provide an innovative solution for complex three-dimensional (3-D) reconstructions. This study aims to evaluate the clinical applicability of 3-D computer-assisted planning and surgery for upper extremity malunions. Hence, we provide a summary of evidence on this topic and highlight recent advances in this field. Further, we provide a practical implementation of this therapeutic approach based on three cases of malunited forearm fractures treated with corrective osteotomy using preoperative three-dimensional simulation and patient-specific surgical guides. All three cases, one female (56 years old) and two males (18 and 26 years old), had painful restrictions in range of motion (ROM) due to forearm malunions and took part in clinical and radiologic assessments. Postoperative evaluation of patient outcomes showed a substantial increase in range of motion, reduction of preoperatively reported pain, and an overall improvement of patients' satisfaction. The therapeutic approach used in these cases resulted in an excellent anatomical and functional reconstruction and was assessed as precise, safe, and reliable. Based on current evidence and our results, the 3-D preoperative planning technique could be the new gold standard in the treatment of complex upper extremity malunions in the future.

Computer-assisted extra-articular distal radius osteotomies using patient-specific surgical guides

10.29007/svbd ◽  
2018 ◽  
Author(s):  
Vasilii Shishkin ◽  
Valeriy Golubev
Keyword(s):  
Distal Radius ◽  
Patient Specific ◽  
Control Group ◽  
Computer Assisted ◽  
X Ray ◽  
Surgical Guides ◽  
Planning Approach ◽  
3D Printed ◽  
Planning Group

Malunions of the distal radius are often treated with correction osteotomies, which can be challenging to perform.In this report, 23 patients with symptomatic distal radius malunions were treated using 3D printed patient-specific surgical guides to facilitate surgery. Patients were compared with a control group of 23 patients that underwent similar surgery with a conventional x-ray planning approach.Postoperatively all patients in the computer-assisted group showed recovery of ROM, with no anatomical abnormalities on x-ray examination. 6 patients in the conventional planning group had reduced ROM with a residual volar tilt on x-ray images.Computer-assisted planning with the use of 3D printed patient-specific surgical guides enhances results of corrective osteotomies of distal radius malunions.

scholarly journals A machine learning framework for automated diagnosis and computer-assisted planning in plastic and reconstructive surgery

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Paul G. M. Knoops ◽  
Athanasios Papaioannou ◽  
Alessandro Borghi ◽  
Richard W. F. Breakey ◽  
Alexander T. Wilson ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Reconstructive Surgery ◽  
Clinical Decision Making ◽  
Specific Treatment ◽  
Operation Time ◽  
Clinical Decision ◽  
Patient Specific ◽  
Computer Assisted ◽  
Plastic And Reconstructive Surgery

Abstract Current computational tools for planning and simulation in plastic and reconstructive surgery lack sufficient precision and are time-consuming, thus resulting in limited adoption. Although computer-assisted surgical planning systems help to improve clinical outcomes, shorten operation time and reduce cost, they are often too complex and require extensive manual input, which ultimately limits their use in doctor-patient communication and clinical decision making. Here, we present the first large-scale clinical 3D morphable model, a machine-learning-based framework involving supervised learning for diagnostics, risk stratification, and treatment simulation. The model, trained and validated with 4,261 faces of healthy volunteers and orthognathic (jaw) surgery patients, diagnoses patients with 95.5% sensitivity and 95.2% specificity, and simulates surgical outcomes with a mean accuracy of 1.1 ± 0.3 mm. We demonstrate how this model could fully-automatically aid diagnosis and provide patient-specific treatment plans from a 3D scan alone, to help efficient clinical decision making and improve clinical understanding of face shape as a marker for primary and secondary surgery.

Computer-Aided Design and Manufacturing of a Novel Maxillofacial Surgery Instrument: Application in the Sagittal Split Osteotomy

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Erol Cansiz ◽  
Fatih Turan ◽  
Yunus Ziya Arslan
Keyword(s):  
Computer Aided Design ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Patient Specific ◽  
Computer Assisted ◽  
Lateral Side ◽  
Sagittal Split Osteotomy ◽  
Surgical Application

Mandibular sagittal split osteotomy (SSO) is an operation performed for the correction of mandibular deformities. In this operation, sharp rotary tools are used during osteotomies and this can induce some complications. For example, if the inferior alveolar nerve is damaged, paralysis of the teeth, the lateral side of the tongue, and the corner of the lip can occur. To decrease the occurrence of such possible complications, we designed and manufactured a novel computer-assisted, patient-specific SSO guide and soft tissue retractor in our previous study. And, we first tested this apparatus on a cadaveric bone in vitro. Now, in this study, a surgical application of the instrument, which was designed and manufactured according to the requirements of the mandibular sagittal split osteotomies, was performed. This paper gives and discusses the results obtained from in vivo application of the apparatus.

scholarly journals Mandibular Reconstruction Using ProPlan CMF: A Review

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1606835 ◽  
Author(s):  
Ryo Sasaki ◽  
Michael Rasse
Keyword(s):  
Computer Assisted Surgery ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Planning Service ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Computer Aided

ProPlan CMF (Depuy Synthes, Solothurn, Switzerland, and Materialise, Leuven, Belgium) is a computer-aided surgical virtual planning service using an online meeting with professional medical engineers and transfers patient-specific surgical guide to the virtual plan. Moreover, prebent reconstruction plates or patient-specific computer-aided manufacturing-fabricated reconstruction can also be used. This service started in 2011. Currently, it is widely used in Europe. Current status of mandibular reconstruction with ProPlan CMF vertical planning service with the surgical guide was reviewed. The accuracy was excellent in terms of contact of the osteotomized parts and the contact to the remaining skeleton. The authors found that currently, a small number of reports regarding the mandibular reconstruction with virtual planning service and surgical guides are available. These reports also have a small number of cases and short-term follow-up results. In this situation, this review revealed that (1) mainly the resection guides, cutting guides, and patient-specific mandible reconstruction plates were adequately well fitted to the surgical site intraoperatively, (2) the ischemic time might be more reduced than that of the conventional surgery (3) the accuracy of computer-assisted surgery in the mandibular reconstruction was clinically acceptable, and (4) condyle positions after the computer-assisted surgery was mainly normal. The higher additional cost than that of the conventional technique is presently an issue. Large-scale clinical studies and long-term follow-up studies are demanded.

Computer-Assisted Virtual Planning for Surgical Guide Manufacturing and Internal Distractor Adaptation in the Management of Midface Hypoplasia in Cleft Patients

2017 ◽  
Vol 54 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Paolo Scolozzi ◽  
Georges Herzog
Keyword(s):  
Computer Aided Design ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Patient Specific ◽  
Computer Assisted ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Patient Specific Implants ◽  
Surgical Guides ◽  
Computer Aided

We are reporting the treatment of severe maxillary hypoplasia in two patients with unilateral cleft lip and palate by using a specific approach combining the Le Fort I distraction osteogenesis technique coupled with computer-aided design/computer-aided manufacturing customized surgical guides and internal distractors based on virtual computational planning. This technology allows for the transfer of the virtual planned reconstruction to the operating room by using custom patient-specific implants, surgical splints, surgical cutting guides, and surgical guides to plate or distractor adaptation.

Three-Dimensional Correction of Complex Ankle Deformities With Computer-Assisted Planning and Patient-Specific Surgical Guides

2017 ◽  
Vol 56 (6) ◽  
pp. 1158-1164 ◽  
Author(s):  
Lizzy Weigelt ◽  
Philipp Fürnstahl ◽  
Stefanie Hirsiger ◽  
Lazaros Vlachopoulos ◽  
Norman Espinosa ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides

scholarly journals Application of a new percutaneous multi-function pedicle locator in minimally invasive spine surgery

2021 ◽  
Author(s):  
Xiaojian Liu ◽  
Hairun Liu ◽  
Yushan Wang
Keyword(s):  
Minimally Invasive ◽  
Spine Surgery ◽  
Three Dimensional ◽  
Operation Time ◽  
Minimally Invasive Spine Surgery ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Freehand Technique ◽  
Potential Benefits ◽  
Minimally Invasive Spine

Abstract A new percutaneous multi-function pedicle locator was designed to be used for personalized three-dimensional positioning of a pedicle in minimally invasive spine surgery without computer-assisted navigation technology. This article instructed the method and advantages of using a new percutaneous multi-function pedicle locator in minimally invasive surgery of the spine. Based on the position of a pedicles suggested by CT and X-ray images of a patient, 6 lines and 2 distances were used to determine the puncture point of a pedicle screw, while 2 angles were used to determine the inserting direction of a pedicle guide needle from the patient's body surface. The result of application of the locator was roughly compared with that of the conventional freehand technique. The potential benefits of using the locator included enhancing surgical accuracy, reducing the operation time, mitigating the harmful intra-operative radiation exposure, saving the costs and shortening the learning curve of young orthopedists. It was hoped that more doctors and patients will benefit from it.

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