Ultrasound-guided percutaneous scaphoid pinning: operator variability and comparison with traditional fluoroscopic procedure.

This paper reports on pilot laboratory experiments with a recently proposed surgical procedure for percutaneous screw insertion into fractured scaphoid bones using ultrasound guidance. The experiments were intended to determine the operator variability of the procedure and its performance in comparison with a traditional pinning procedure using fluoroscopy. In the proposed procedure, a three-dimensional surface model is created from pre-operative computed tomography images and intra-operatively registered to the patient using ultrasound images. A graphical interface that communicates with an optical camera tracking the surgical tools, guides the surgeon during the procedure in real time. The results of the experiments revealed non-significant differences between operators for the error in the entry location of the drill hole (p=0.90); however, significant differences for the exit location (p<0.05). Comparison with the traditional pinning procedure shows that the outcome of the recently proposed procedure appears to be more consistent.