[Determining the femoral antetorsion angle with a fluoroscopy-based optoelectronic navigation system: a precision...

According to the literature, differences in torsion of 15 degrees and more develop in 20-30% of cases after intramedullary nailing of femoral shaft fractures. A computer-assisted method makes it possible to determine the antetorsion angle during surgery. In this experimental study, the precision of the measurements obtained with the navigation system were checked with a femur model and compared with a CT reference method. The measurements are carried out on a femur model that is equipped with a rotation device in the middle of the shaft. Nine reproducible angles can be set. Two investigators each conduct the measurements of the antetorsion angle ten times. A comparison is drawn between the absolute values of the antetorsion angle measured and the difference values of the adjoining positions. When comparing the absolute values of the navigation and reference systems, the mean deviations of both methods are around 1 degrees (0.35; 1.75) and comparing the differences 0.5 degrees (-0.2; 1.17). The maximum deviation of the absolute values of the CT reference method amounts to 6.4 degrees . Under experimental conditions, measurement of the femoral antetorsion angle proved to be sufficiently precise for clinical specifications in comparison to a CT reference method.