Post-traumatic Triradiate Cartilage Physeal Bar Excision with 3D Navigation: A Case Report

Area of Science:

• Pediatric Orthopedics
• Surgical Navigation Technology
• Medical Imaging

Background:

• Pelvic and femoral fractures in children can lead to growth disturbances.
• Triradiate physeal bars are a known complication, potentially causing limb length discrepancies and deformities.
• Surgical intervention is often required to correct these deformities.

Purpose of the Study:

• To describe the use of O-arm navigation for triradiate physeal bar excision in a pediatric patient.
• To evaluate the efficacy and safety of a navigated, low-dose radiation approach for this complex procedure.

Main Methods:

• Open reduction and internal fixation for initial pelvic and femoral fractures.
• Computed tomography (CT) to identify the triradiate physeal bar.
• Intraoperative O-arm navigation for navigated physeal bar excision.
• Implementation of a low-dose radiation protocol.

Main Results:

• Successful excision of the triradiate physeal bar was achieved using O-arm navigation.
• The navigated approach facilitated accurate localization and complete removal of the bar.
• The low-dose radiation protocol resulted in minimal radiation exposure (0.914 mSv).

Conclusions:

• O-arm navigation is a valuable tool for technically challenging physeal bar excisions.
• This technology allows for accurate, real-time imaging, improving surgical precision.
• The navigated, low-dose radiation approach is safe and effective in pediatric orthopedic surgery.