Radioscopically based computer assisted surgery in the treatment of intertrochanteric hip fractures

摘要

Objectives: To evaluate the theoretic advantages of a computed assisted system for minimally invasive surgery in orthopaedics [2, 3,9]. Background: Minimally invasive orthopaedic surgery reduces soft tissue aggression, improves fracture healing time with less wound complications. We developed, following these goals, a percutaneous technique for the treatment of intertrochanteric hip fractures using a standard hip sliding screw system [1, 4, 5, 6, 7, 8, 10]. Design/Methods: A prospective nonrandomized trial was performed evaluating two groups (A and B) of 10 patients each diagnosed with an intertrochanteric hip fracture and treated using this mentioned percutaneous technique. In group B a radioscopically based computed assisted navigation system was used in one step of the surgery (location of the femoral head screw). Surgical and total radiation time was registered. The sliding screw's position was documented using post-op X-rays being the goal the center of the femoral head in both AP and lateral views (2-2 zone). Results: The surgical time for group A averaged 76 minutes (range 45 to 95 minutes). For group B averaged 71 minutes (range 42 to 170 minutes). The radiation time averaged 10.6 minutes (range 2.4 to 24 minutes) for group A and 0.9 minutes (rangeO.2 to 2.2 minutes) in group B. The post-op X-rays showed that just two of 10 patients in group A had their screw in the center of the femoral head. On the other hand, 7 of 10 patients in group B showed a correct position. Conclusions: In this short experience, the radioscopically based computed system proved to be reliable, with a significant reduction in radiation time (90%) and with no complication to screw positioning.