Computerized navigation for the internal fixation of femoral neck fractures.
BACKGROUND
Accurate placement of cannulated screws is essential to ensure secure fixation of femoral neck fractures. We compared computerized navigation and conventional fluoroscopy with regard to the accuracy of screw placement for the fixation of femoral neck fractures.


METHODS
We retrospectively compared two groups of twenty consecutive patients with a femoral neck fracture who underwent internal fixation with three cannulated screws. Computer-based navigation was used to guide screw placement in one group, and conventional fluoroscopy was used in the other group. Radiographic evaluation included the measurement of screw parallelism and spread, the calibrated distance from the lesser trochanter, and joint penetration. The follow-up period was two years. The rates of complications in both groups were evaluated.


RESULTS
The navigation-assisted group had better screw parallelism and greater spread of the screws. There was a tendency for fewer reoperations and significantly fewer overall complications in the patients in whom computerized navigation was used (p < 0.018).


CONCLUSIONS
Computerized navigation improves the accuracy of cannulated screw placement in the internal fixation of femoral neck fractures. It may provide better mechanical stability and improved fracture outcome.
Liebergall
Meir
M
Department of Orthopedic Surgery, Hadassah-Hebrew University Medical School, Hadassah Medical Center, P.O. Box 12000, Jerusalem 91120, Israel. liebergall@hadassah.org.il
Ben-David
Dror
D
Weil
Yoram
Y
Peyser
Amos
A
Mosheiff
Rami
R
D000368:Aged; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted