title: Fluoroscopic guidance versus surgical navigation for distal locking of intramedullary implants. A prospective, controlled clinical study.
abstract: A prospective controlled clinical study was performed to compare fluoroscopic guidance with fluoroscopy-based surgical navigation for distal locking of intramedullary implants. Forty-two patients with fractures of the lower extremity treated by intramedullary nailing were divided in two groups: distal locking either with fluoroscopic guidance (group I) or with surgical navigation (group II). The average fluoroscopic time to insert one interlocking screw with fluoroscopic guidance was 108 s compared with 7.3s in the navigation group. The average procedure time to insert one interlocking screw in group I was 13.7 min compared with 17.9 min in group II. The drill bit failed to pass through the interlocking hole in one patient from group II. There was no significant difference in the technical reliability between both groups. Fluoroscopic times to achieve equivalent precision are reduced with fluoroscopy-based surgical navigation compared with fluoroscopic guidance. Fluoroscopy-based surgical navigation is recommended for intraoperative guidance in situations where reduction of exposure to radiation is considered advantageous over the increase of procedure time.
authors.affiliation: Department of Surgery, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland. nsuhm@web.de
authors.forename: Norbert
authors.initials: N
authors.lastname: Suhm
authors.forename: Peter
authors.initials: P
authors.lastname: Messmer
authors.forename: Ivan
authors.initials: I
authors.lastname: Zuna
authors.forename: Ludwig A
authors.initials: LA
authors.lastname: Jacob
authors.forename: Pietro
authors.initials: P
authors.lastname: Regazzoni
mesh_terms: D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D005471:Fluoroscopy / Q000295:instrumentation*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013978:Tibial Fractures / Q000601:surgery