Journal of orthopaedic trauma · 2014
Computerized navigation for length and rotation control in femoral fractures: a preliminary clinical study.
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Weil Yoram A, Greenberg Alexander, Khoury Amal, Mosheiff Rami, Liebergall Meir
Аннотация
OBJECTIVE: Operative treatment of femoral fractures yields a predictably high union rate, but residual malrotation and leg length discrepancy remain a clinically significant problem. The aim of this study was to determine the safety and efficacy of using computerized navigation in controlling the length and rotation in femoral fracture surgery.
DESIGN: Prospective consecutive case series of 16 skeletally mature patients with femoral fractures undergoing surgical fixation; 14 were fixed with intramedullary nails and 2 with plates.
SETTING: An Academic Level I trauma center.
INTERVENTION: Computerized navigation was used to determine the length and rotation of the operated extremity as compared with the intact healthy contralateral side.
MAIN OUTCOME MEASURE: All patients underwent postoperative computed tomography scanogram for determining the length and rotation.
RESULTS: All fractures healed. Mean rotational difference between the treated and nontreated sides was 3.45 degrees (range, 0-7.7 degrees). Mean length difference between the 2 extremities as calculated by the computed tomography scan was 5.83 mm (range, 0-13 mm). Additional operative time required for computerized navigation was measured in 2 of the cases and totaled ∼30-35 min/case.
CONCLUSION: Computerized navigation was accurate and precise at restoring femoral length and rotation during femoral fracture fixation when the intact contralateral femur was used for reference. Further, large-scale randomized studies are required. Additionally, improvements aimed at decreasing operative time and improving user interface of these systems are recommended.
LEVEL OF EVIDENCE: Therapeutic level IV. See instructions for authors for a complete description of the levels of evidence.
DESIGN: Prospective consecutive case series of 16 skeletally mature patients with femoral fractures undergoing surgical fixation; 14 were fixed with intramedullary nails and 2 with plates.
SETTING: An Academic Level I trauma center.
INTERVENTION: Computerized navigation was used to determine the length and rotation of the operated extremity as compared with the intact healthy contralateral side.
MAIN OUTCOME MEASURE: All patients underwent postoperative computed tomography scanogram for determining the length and rotation.
RESULTS: All fractures healed. Mean rotational difference between the treated and nontreated sides was 3.45 degrees (range, 0-7.7 degrees). Mean length difference between the 2 extremities as calculated by the computed tomography scan was 5.83 mm (range, 0-13 mm). Additional operative time required for computerized navigation was measured in 2 of the cases and totaled ∼30-35 min/case.
CONCLUSION: Computerized navigation was accurate and precise at restoring femoral length and rotation during femoral fracture fixation when the intact contralateral femur was used for reference. Further, large-scale randomized studies are required. Additionally, improvements aimed at decreasing operative time and improving user interface of these systems are recommended.
LEVEL OF EVIDENCE: Therapeutic level IV. See instructions for authors for a complete description of the levels of evidence.