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Related Experiment Videos

Fracture-table-mounted versus bone-mounted dynamic reference frame tracking accuracy using computer-assisted

Idan Ilsar1, Yoram A Weil, Leo Joskowicz

  • 1Department of Orthopedic Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.

Computer Aided Surgery : Official Journal of the International Society for Computer Aided Surgery
|May 10, 2007
PubMed
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Computerized navigation for femoral neck fractures is accurate whether the dynamic reference frame (DRF) is attached to bone or the fracture table. This finding suggests reduced surgical trauma is possible without compromising accuracy.

Area of Science:

  • Orthopedic Surgery
  • Medical Technology
  • Surgical Navigation

Background:

  • Fluoroscopy-based computerized navigation enhances implant accuracy and reduces radiation.
  • Current methods require attaching a dynamic reference frame (DRF) to bone, increasing surgical trauma.

Purpose of the Study:

  • To compare the accuracy of computerized navigation for femoral neck fracture fixation.
  • To evaluate DRF placement on bone versus a fracture table.

Main Methods:

  • Prospective study of 10 patients undergoing femoral neck fracture fixation with cannulated screws.
  • DRF was repositioned from bone to fracture table after guide wire insertion.
  • Angular and translational deviations were analyzed comparing navigated and fluoroscopic images.

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Main Results:

  • Navigated Kirschner wire placement accuracy was similar with both DRF techniques.
  • Average translational error was <2 mm and angulation error was ~1 degree for both groups.
  • Accuracy measurements are sufficient for cannulated screw insertion into the femoral head.

Conclusions:

  • Attaching the DRF to a fracture table offers acceptable accuracy for navigated femoral neck fixation.
  • This technique may reduce patient morbidity by avoiding bone attachment of the DRF.