Influence of the Vertek aiming device on the surgical accuracy of computer-assisted drilling of the equine distal sesamoid bone-An experimental cadaveric study.
Authors: de Preux Mathieu, Precht Christina, Travaglini Andrea T, Propadalo Ljubo M, Farra Dima, Vidondo Beatriz, Easley Jeremiah T, Koch Christoph
Journal: Veterinary surgery : VS
Summary
Computer-assisted surgical navigation has enhanced precision in equine orthopaedics, yet the technical challenge of maintaining accurate drill trajectory remains particularly demanding in distal sesamoid bone (DSB) fracture repair, where millimetre-level deviations can compromise construct stability and load distribution. Researchers compared navigated drilling accuracy for mid-sagittal DSB fractures across 30 paired cadaveric limbs, evaluating whether addition of the Vertek aiming device (VAD)—a mechanical guidance system—could reduce surgical accuracy aberrations when combined with pre-operative cone beam CT imaging and intraoperative navigation. Median surgical accuracy aberrations decreased significantly with VAD assistance (0.6 mm versus 0.8 mm without the device, p = 0.007), with both groups maintaining maximum deviations under 3 mm. For practitioners performing navigated lag screw repair of DSB fractures, incorporating the VAD as an adjunct to image-guided surgery represents a practical, evidence-based refinement that could reduce screw malposition, particularly relevant given the demanding anatomy of the distal sesamoid and the low tolerance for error in tension-band constructs where thread hole placement is critical for functional healing.
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Practical Takeaways
- •Using the Vertek aiming device during navigated DSB fracture repair improves drill hole accuracy by approximately 25%, potentially reducing complications from malpositioned implants
- •This technique requires pre-operative CBCT imaging and surgical navigation systems, limiting availability to referral centers with advanced equipment
- •For surgeons performing navigated DSB repairs, adding the VAD to your setup is a straightforward way to enhance surgical precision without significantly altering technique
Key Findings
- •Median surgical accuracy aberration was significantly lower with VAD assistance (0.6 mm) compared to free-hand navigated drilling (0.8 mm, p=0.007)
- •VAD-assisted drilling reduced maximum deviation to 2.8 mm versus 2.9 mm in free-hand group
- •The Vertek aiming device improved precision in computer-navigated lag screw placement for distal sesamoid bone repair