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Neal et al: The effect of an aiming device on the accuracy of humeral transcondylar screw placement
Veterinary Surgery 4, 2023

🔍 Key Findings

  • Aiming device provided comparable trajectory accuracy to fluoroscopy, especially in right limbs (1.9° vs. 3.4°, p = .0128).
  • Eccentricity (deviation from condylar center) was lower with fluoroscopy (3.1 mm vs 4.2 mm, p = .0017), making fluoroscopy more precise.
  • Odds of joint infringement were 8× higher with the aiming device, though not statistically significant (p = .0575).
  • Residents had greater screw trajectory deviation than diplomates (p = .0366), highlighting impact of experience.
  • Aiming device procedures took less time than fluoroscopy in some scenarios, particularly for right limbs with right-handed surgeons.
  • Fluoroscopic procedures had more pin/drill attempts, increasing risk of glove puncture and potential aseptic breaks.
  • Mean deviation angles in both groups (<3.5°) were within acceptable range to avoid intracondylar fracture gap.
  • Cadaver model used large-breed, healthy adult dogs, not small-breed immature dogs, limiting generalizability.

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← Articles

Neal et al: The effect of an aiming device on the accuracy of humeral transcondylar screw placement
Veterinary Surgery 4, 2023

🔍 Key Findings

  • Aiming device provided comparable trajectory accuracy to fluoroscopy, especially in right limbs (1.9° vs. 3.4°, p = .0128).
  • Eccentricity (deviation from condylar center) was lower with fluoroscopy (3.1 mm vs 4.2 mm, p = .0017), making fluoroscopy more precise.
  • Odds of joint infringement were 8× higher with the aiming device, though not statistically significant (p = .0575).
  • Residents had greater screw trajectory deviation than diplomates (p = .0366), highlighting impact of experience.
  • Aiming device procedures took less time than fluoroscopy in some scenarios, particularly for right limbs with right-handed surgeons.
  • Fluoroscopic procedures had more pin/drill attempts, increasing risk of glove puncture and potential aseptic breaks.
  • Mean deviation angles in both groups (<3.5°) were within acceptable range to avoid intracondylar fracture gap.
  • Cadaver model used large-breed, healthy adult dogs, not small-breed immature dogs, limiting generalizability.

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Multiple Choice Questions on this study

In Neal 2023 et al., on transcondylar screw placement, what was the observed rate of joint infringement when using the aiming device?

A. 1.5%
B. 10%
C. 20%
D. 0%
E. 15%

Answer: 10%

Explanation: Joint infringement occurred in 10% of aiming device cases vs. 1.45% with fluoroscopy (8x risk, p = .0575).
In Neal 2023 et al., on transcondylar screw placement, which variable significantly influenced screw trajectory deviation regardless of method used?

A. Surgeon experience
B. Leg side
C. Surgical time
D. Screw type
E. Condyle radius

Answer: Surgeon experience

Explanation: Residents had significantly more deviation (3.4° vs 2.5°) than diplomates, p = .0366.
In Neal 2023 et al., on transcondylar screw placement, which technique had more drill/pin attempts, increasing risk of glove puncture and contamination?

A. Aiming device
B. Fluoroscopy
C. Both equally
D. Preoperative CT planning
E. None of the above

Answer: Fluoroscopy

Explanation: Fluoroscopy resulted in significantly more pin/drill attempts and increased glove punctures.
In Neal 2023 et al., on transcondylar screw placement, which method had lower screw eccentricity on the humeral condyle?

A. Aiming device
B. Fluoroscopy
C. Equal between both
D. CT-based planning
E. Depends on experience

Answer: Fluoroscopy

Explanation: Fluoroscopy achieved significantly better screw centering on the condyle (3.1 mm vs 4.2 mm, p = .0017).
In Neal 2023 et al., on transcondylar screw placement, what was the main finding comparing trajectory angle between aiming device and fluoroscopy in right thoracic limbs?

A. Aiming device produced more deviation than fluoroscopy
B. Both had similar deviation angles
C. Fluoroscopy produced less deviation than aiming device
D. Aiming device produced less deviation than fluoroscopy
E. Fluoroscopy showed 10° lower deviation

Answer: Aiming device produced less deviation than fluoroscopy

Explanation: Aiming device had significantly less trajectory deviation in right limbs (1.9° vs 3.4°, p = .0128).

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