Comparison of 3D C-arm fluoroscopy and 3D image-guided navigation for minimally invasive pelvic surgery.
OBJECTIVE
This study aims to compare the efficacy and accuracy of percutaneous screw fixation using three-dimensional [Formula: see text] navigation and conventional C-arm fluoroscopy in pelvic fracture surgery.


METHODS
This was a retrospective study of 81 patients with pelvic fractures treated using percutaneous screw fixation between June 2005 and January 2011. All pelvic fractures were treated with closed reduction, small open reduction, or medium open reduction. Intraoperative radiation exposure, fixation, surgical outcome, and functional recovery were compared based on the fluoroscopy navigation method used during screw fixation. Radiographic follow-up was assessed at 1, 3, 6, and 9 months postoperatively, and a CT scan was completed at 9 months postoperatively.


RESULTS
A total of 130 cannulated screws were placed. Average screw fixation time and fluoroscopy exposure time in [Formula: see text] group were lower than the C-arm fluoroscopy group ([Formula: see text] vs [Formula: see text]) [Formula: see text]. Seventy-four of the 81 patients made a full recovery. Successful outcome was confirmed with radiological imaging and postoperative follow-up at 6-24 months. No delayed union or nonunion was detected. No significant difference in functional recovery at 6 months postoperative was found due to the fluoroscopy imaging technique.


CONCLUSIONS
Percutaneous screw fixation using the [Formula: see text] navigational system minimizes the fluoroscope exposure and screw insertion time, while improving screw insertion accuracy. Moreover, the [Formula: see text] navigational system provided a reliable method for fluoroscopy imaging in pelvic fractures.
Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
Bin
B
Li
Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
Jiliang
J
He
Department of Orthopaedics, General Hospital of the Second Artillery, Beijing, 100088, China.
Zexing
Z
Zhu
Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
Dongsheng
D
Zhou
Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China. zhenhaihao@126.com.
Zhenhai
Z
Hao
Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
Yonghui
Y
Wang
Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
Qinghu
Q
Li
D000328:Adult; D001863:Bone Screws; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
Cannulated lag screws; Computer-assisted; Fractures; Minimally invasive; Pelvis