Influence of the Vertek aiming device on the surgical accuracy of computer-assisted drilling of the equine distal sesamoid bone - An experimental cadaveric study

To determine the effect of the Vertek aiming device (VAD) on the surgical accuracy of navigated drilling of the distal sesamoid bone (DSB). Study design: Experimental cadaveric study. Sample population: A total of 30 paired equine cadaveric limbs from 15 horses. Methods: Each specimen was placed in a purpose‐built frame (PBF). Preoperative cone beam computed tomography (CBCT) images were acquired with an imaging unit coupled with a surgical navigation system. In the DSB of each specimen, a 4.5 mm glide hole and a 3.2 mm thread hole were drilled under navigation guidance, to simulate drilling for the repair of a mid‐sagittal DSB fracture. In the VAD group navigated drilling was assisted by using the VAD. In the free‐hand drilling group navigated drilling was performed without the VAD. Pre‐and postoperative CBCT scans were merged and surgical accuracy aberrations (SAA) between the planned drill corridor and the created bone tunnel were measured. Descriptive statistics and repeated‐measures analyses of variance (rep.‐meas. ANOVA) were performed to compare SAA measurements between the study groups. Results: The SAA measurements ranged from 0 to 2.9 mm in the free‐hand group and from 0 to 2.8 mm in the VAD group. The median overall SAA was lower in the VAD group than in the free‐hand navigated group (0.6 mm ± [0.5–0.7] vs. 0.8 mm ± [0.7–1], rep.‐meas. ANOVA = .007). Conclusion: The additional use of the VAD in the described set‐up for navigated drilling significantly improved surgical accuracy. Clinical significance: The combined use of the VAD and PBF may help improve surgical accuracy in navigated lag screw repair of DSB fractures.