Summary: Clinical Paper
Fixation-Based Surgery: A New Technique for Distal
H. Croitoru, M.SC., R.E. Ellis, Ph.D., R. Prihar, M.D., C.F. Small, Ph.D., and D.R. Pichora, M.D.
Departments of Computing and Information Science (H.C., R.E.E.), Mechanical Engineering (R.E.E.,
C.F.S., D.R.P.), and Surgery (R.E.E., R.P., C.F.S., D.R.P.), Queen's University,
Kingston, Ontario, Canada
ABSTRACT Objective: The objective was to develop a fixation-based three-dimensional presur-
gical planner and an intraoperative guidance system for distal radius osteotomy. Fixation-based
surgery is a technique premised on using a fixation device, such as a fracture-fixation plate, during the
alignment and distraction phases of an osteotomy.
Materials and Methods: The planning system and guidance system were coded using
OpenGL on UNIX workstations. In vitro tests were performed to compare the reproducibility of the
computer-enhanced technique to that of the traditional technique, and an in vivo pilot study was
Results: In vitro, the computer-enhanced technique produced a significant reduction by
more than one half in both the maximum error of correction and the standard deviation of the
correction error. Preliminary in vivo results on six patients suggest that similar error diminution will
occur during regular clinical application of the technique.
Conclusions: Both studies showed that the computer system is simple to use. The planning