Difficulties of Planning and Identifying Incision Sites in Orthopaedic Procedures and the Applicability of an X-Grid Localization Aid
Dr. Pierre Guy | Orthopaedic Trauma Surgeon, Vancouver General Hospital
Dr. Piotr Blachut | Orthopaedic Trauma Surgeon at Vancouver General Hospital
White Paper
Abbreviated version
The following is an abbreviated white paper of an X-Grid human cadaver test analyzing the efficacy and accuracy of using a radiopaque grid to find randomized targets. The localization was compared to tries without the grid.
Problem
Without fluoroscopic assistance, the surgeon is dependent upon palpation and eye-balling distances, which can prove inaccurate and time consuming, creating longer incisions.
Dependency upon fluoroscopy for localizing can lead to unnecessary radiation exposure, as the current method is cumbersome and requires multiple fluoroscopy shots to localize a position.
Results
Target Tape X-Grid radiopaque adhesive stickers are applied to a patient’s skin over the area of interest. A grid pattern on the sticker shows up in medical imaging scans. It may be applied before or during a procedure, providing key visual landmarks to localize positions accurately.
The X-Grid device simplifies the procedure, eliminating dependencies on palpation and eye-balling. On average, the surgeon was five-times more accurate in their localization and required six-times less radiation.
Figure 1.1 With X-Grid, 2 fluoroscopic X-rays were needed in order to localize the surgical site on the tibia.
Figure 2.1 With X-Grid, a point in the hip socket was localized with a single fluoroscopic X-ray.
Figure 3 With X-Grid, the target in the hand was localized with 2 fluoroscopic X-rays.
Figure 1.2 Without X-Grid,7 fluoroscopic X-rays were needed in order to localize the surgical site on the tibia.
Figure 2.2 Without X-Grid, 5 fluoroscopic X-rays were needed in order to localize the hip target.
Figure 4 With X-Grid, a target vein was localized with a single fluoroscopic X-ray.