Fluoroscopy-based computer assistance used for reduction and internal fixation of long bone fractures

摘要

Introduction: Since the 1990s, computer-assisted methods have been well-established in the field of orthopaedics and traumatology. Computer-assisted orthopaedic surgery slowly is making its way into routine orthopaedic practice. Orthopaedic trauma has long been identified as a potential impact area of this new technology. Reduction is one of the key procedures in orthopaedic trauma surgery and has been acknowledged as one of the conditions for a good outcome in fracture treatment. The information available to the surgeon during the reduction maneuver can be divided into visual and tactile information. In-traoperative fluoroscopy is the tool for indirect visual intraoperative control of long bone fracture reduction and osteosynthesis. Limitations of this technology include: High radiation exposure to the patient and especially to the surgical team, limited field of view, image distortion, limitation to 2D representations, and cumbersome updating of verification images. Anatomical regions where a limited direct view during the nailing is supported by intensive intraoperative imaging are especially femoral and tibial shafts. Surgery in these regions is demanding since the closed surgery limits the visual control of the anatomical reduction in axes and rotation.