TY - JOUR
T1 - Computerized navigation for length and rotation control in femoral fractures
T2 - A preliminary clinical study
AU - Weil, Yoram A.
AU - Greenberg, Alexander
AU - Khoury, Amal
AU - Mosheiff, Rami
AU - Liebergall, Meir
PY - 2014/2
Y1 - 2014/2
N2 - 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.
AB - 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.
KW - anteversion
KW - femur fracture
KW - malrotation
KW - navigation
UR - http://www.scopus.com/inward/record.url?scp=84894093522&partnerID=8YFLogxK
U2 - 10.1097/BOT.0b013e31829aaefb
DO - 10.1097/BOT.0b013e31829aaefb
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C2 - 23695376
AN - SCOPUS:84894093522
SN - 0890-5339
VL - 28
SP - e27-e33
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
IS - 2
ER -