Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 1998
Computer assisted orthopaedic surgery. Image guided and robotic assistive technologies.
Technologies are emerging that will influence the way in which orthopaedic surgery is planned, simulated, and performed. Recent advances in the fields of medical imaging, computer vision, and robotics have provided the enabling technologies to permit computer aided surgery to become an established area which can address clinical needs. ⋯ The goals of these new clinically focused technologies are to develop interactive, patient specific preoperative planners to optimize the performance of surgery and the postoperative biologic response, and develop more precise and less invasive interactive smart tools and sensors to assist in the accurate and precise performance of surgery. The medical community is beginning to see the benefit of these enabling technologies which can be realized only through the collaboration and combined expertise of engineers, roboticists, computer scientists, and surgeons.
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Elbow arthroplasty most commonly is performed through a posterior approach by detaching or reflecting the triceps off the olecranon. Surgical approaches to the elbow joint that dissociate the triceps from the olecranon have distinct disadvantages. ⋯ To avoid these complications a modified posterior approach to the elbow joint that preserves the triceps muscle insertion on the olecranon was used in 10 consecutive elbow arthroplasties. This method provides adequate exposure, allows early rehabilitation, and avoids triceps weakness.
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Clin. Orthop. Relat. Res. · Sep 1998
Comparative StudyPercutaneous iliosacral screw placement using image guided techniques.
A computer assisted technique of iliosacral screw placement that is applicable to unstable pelvic ring fractures is proposed. The goals are to operate noninvasively with a percutaneous procedure to decrease the complications of surgical exposure and to provide greater accuracy in locating the close neurovascular structures. Preoperative computed tomographic images of the pelvis are provided and a computed tomography three-dimensional model is built. ⋯ Four human anatomic specimen pelves were tested with three screw insertions for each pelvis (12 screws). All of the screws were considered to be placed correctly. The method is safe and encourages the start of clinical application.