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Updated: May 13, 2026

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
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2D-fluoroscopic based navigation for Gamma 3 nail insertion versus conventional procedure- a feasibility study.

A Wilharm1, I Marintschev, G O Hofmann

  • 1Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Jena, Erlanger Allee 101, Jena 07747, Germany. Arne.Wilharm@med.uni-jena.de

BMC Musculoskeletal Disorders
|March 2, 2013
PubMed
Summary

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2D-fluoroscopic navigation significantly reduces radiation exposure during Gamma3 nail insertions for proximal femoral fractures. This technique maintains accuracy and operating time, offering a safer alternative for surgeons and patients.

Area of Science:

  • Orthopedic Surgery
  • Medical Imaging
  • Surgical Navigation

Background:

  • Intramedullary nailing is standard for proximal femoral fractures.
  • Percutaneous insertion leads to significant radiation exposure.
  • The Gamma3 nail is commonly used for these procedures.

Purpose of the Study:

  • Evaluate 2D-fluoroscopic navigation for Gamma3 nail insertions.
  • Assess reduction in radiation exposure.
  • Determine impact on procedure time and accuracy.

Main Methods:

  • Twenty randomized Gamma3 nail insertions in synthetic femora.
  • Group I: Standard procedure; Group II: 2D-fluoroscopic navigation.
  • Measured procedure time, radiation exposure, and accuracy via CT scans.

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Main Results:

  • No technical issues in either group.
  • Equivalent overall operating time (p=0.06).
  • Significantly reduced radiation exposure (92% fewer images, 91% less time, p<0.01).

Conclusions:

  • 2D-fluoroscopic navigation reduces radiation exposure for Gamma3 nail insertion.
  • Accuracy and operating time remain equivalent.
  • This method is promising but requires further clinical validation.