Dr Donald Triolo DPM
Dr Triolo uses G-Arm version GXi-2 at the busy Alvarado clinic in San Diego. This is what he told us about a recent experience using G-Arm for a particularly challenging procedure.
Procedure: K-wire removal
“Couldn’t have done the case without the G-Arm!”
The G-Arm made a difficult procedure much easier. I had to remove a buried K wire from a metatarsal that was used to fixate an osteotomy several months ago. Unfortunately, the K wire was driven too far and the distal tip was impaling an adjacent metatarsal base. The proximal end of the K wire had been cut flush with the metatarsal shaft so there was nothing sticking out of the bone, making it difficult to remove. The procedure required localization of the K wire with flouroscopy and removal of a plug of bone over the proximal end of the K wire with a trephine.
The most difficult part of the procedure is locating the proper spot over the K wire to remove a 3mm cortical plug exposing the end of the K wire so that it can be grabbed and removed. Locating the K wire requires visualization in 2 planes while holding the trephine against the cortex and making needed adjustments to the location of the trephine until it is located directly over the end of the K wire.
You can imagine how difficult this would be if using a traditional C arm, where the head had to be relocated for each AP and lateral x-ray. It was a breeze with the simultaneous AP and lateral views available on the G arm. The image was excellent after adjusting the kvp and contrast. The tech who operated the G arm was very good but I imagine that the techs will get even better with more experience. Making minor corrections to the position of the trephine was so easy with both views available simultaneously that I was able to position the trephine perfectly and removed the plug in the exact position that I needed to exposed the base of the K wire and remove it.
What a great aid the G arm was! I can’t say enough about how easy it made positioning the trephine. I imagine that it would be very useful anytime a buried pin, K wire or broken screw needed to be removed. I also imagine that it will be helpful in fixating an osteotomy where one is concerned about the position of the bone on both a frontal and sagittal plane. Can’t wait to try that! In any event, I don’t see why this unit doesn’t become the standard because I can’t imagine many circumstances when both an AP and lateral view are not required and the ease with which this can be done with this unit is outstanding. Thanks for an excellent piece of technology!
Donald Triolo DPM
Dr Hussein Abdulhadi, MD
Dr Abdulhadi has had the opportunity to use G-Arm GXi-2 for a number of procedures and found it to improve workflow and effectiveness.
Procedures: Cervical ESI C7-T1, Transforaminal ESI, L – ESI and Selective Nerve Root Blocks.
“The G-Arm is easy to use and gives you two plane X-Rays at the same time. Improves accuracy and efficiency.”
Dr Hussein Abdulhadi, MD
Certification: American Board of Pain Medicine, board certified physical medicine and rehabilitation, board certified internal medicine.