Computernavigierte Osteosynthese der langen Röhrenknochen

Abstract

Following its test in 10 osteomized bone syntheses, we used the navigation system (Brainlab) for patients with complex femoral shaft fractures. We always performed a preoperative computed tomography of the opposite uninjured leg to analyse the axis and fixed the fractured leg on these parameters using the navigation system. Differences in length and torsion as established on CT for intraoperative measurement, the duration of the surgical procedure, as well as the radiation exposure were assessed. There were no technical problems during navigation-assisted operations and the accuracy in the synthetic bone model was ±5 and ±2 mm. As a result, 20 fully navigated femoral shaft surgical procedures were performed. The average time required to instal the navigation system was 35 min and an additional X-ray time of 45 s was required. The average postoperative rotational deviation was 5.4, while the average difference in leg length was 3 mm. Thus, although application of the navigation system for reduction of femoral shaft axes and control of length and torsion while nailing complex femoral shaft fractures is associated with some additional work, relevant postoperative rotational deviation could be avoided by its use. This advantage, however, needs to be established in clinical studies with higher case numbers. © Springer Medizin Verlag 2008.