CT (ISO-C-3D) image based computer assisted navigation in trauma surgery: A preliminary report

CT (ISO-C-3D) image based navigation has recently been introduced to improve the image quality and accuracy during computer assisted orthopaedic surgeries. We report on our early experience using this novel technique in intra-articular lower extremity fracture management. Real time CT-based navigation assisted surgery was used in the treatment of five patients with fractures of tibial plateau (3), talus (1) and acetabulum (1). The mean age was 38 years (range, 29–47). Feasibility, pitfalls and adequacy of reduction and fixation were evaluated. Additional time spent before the surgical incision (Δ time) using the ISO-C navigation and total operative time was measured. All five procedures were regarded as technically successful. Accurate reduction and fixation of all the fractures was achieved. All the fractures were fixed with closed reduction and internal cannulated screw fixation. Mean additional time spent after the start of anaesthesia and until surgical incision for cannulated screw insertion (Δ time) was 26 min. The average total operative time was 109 min. Combining the ISO-C-3D images with computer navigation can improve the safety and decrease the invasiveness of the procedures in trauma surgery. 3D navigation makes the reduction and screw placement highly accurate but may extend the operative time.