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BMC Musculoskeletal Disorders

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Open Access 01-12-2013 | Research article

2D-fluoroscopic based navigation for Gamma 3 nail insertion versus conventional procedure- a feasibility study

Authors: A Wilharm, I Marintschev, G O Hofmann, F Gras

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

Abstract

Background

Intramedullary nailing is a standard surgical procedure for fixation of proximal femoral fractures, but is associated with considerable radiation exposure for controlling the implant placement, due to the percutaneous insertion technique.

The aim of this study was the evaluation of potential benefits of 2D-fluoroscopic based navigation focused on the reduction of radiation exposure, a decrease of procedure time, as well as an increase of accuracy for Gamma3 nail insertions.

Methods

Twenty randomized Gamma3 nail insertions were performed in non-fractured synthetic femora according to the manufactures operation guidelines (group I) or with use of a 2D-fluoroscopic based navigation system (group II). Time of different steps of the procedure and the radiation exposure were measured, as well as the accuracy evaluated in postoperative CT scans.

Results and discussion

All Gamma3 nails were placed without any technical problems. Independent of the used procedure, the overall operating time (group I: 584 ± 99.2 sec; group II: 662 ± 64.9 sec; p=0.06) and accuracy of the final nail-positions were equivalent, but the radiation exposure was significantly reduced (92% reduction in fluoroscopic images and 91% reduction in fluoroscopic time, p< 0.01), using the 2D fluoroscopic based navigation procedure.

Conclusions

2D-fluoroscopic based navigation for Gamma3 nail insertion facilitates a relevant reduction of radiation exposure with equivalent accuracy of the final implant position and no prolonged operating time. This promising procedure modification is independent of different cephalomedullary implant manufacturers and specific implant designs, but needs to be evaluated in further clinical settings.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/14/74/prepub

Title: 2D-fluoroscopic based navigation for Gamma 3 nail insertion versus conventional procedure- a feasibility study
Authors: A Wilharm
I Marintschev
G O Hofmann
F Gras
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-14-74

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

2D-fluoroscopic based navigation for Gamma 3 nail insertion versus conventional procedure- a feasibility study

Abstract

Background

Methods

Results and discussion

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results and discussion

Conclusions

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