Computer-assisted image-guided intramedullary nailing of femoral shaft
fractures

Eric J. Hazan (1) and Leo Joskowicz (2)

(1) División de Traumatología, Hospital de Ortopedia, Centro Nacional de
    Rehabilitación Ave. Mexico-Xochimilco 289, Mexico 14389 DF, Mexico.

(2) School of Computer Science and Engineering, The Hebrew University of
Jerusalem,

Abstract 

Closed reduction and intramedullary nailing under X-Ray fluoroscopy is the
current treatment of choice for femoral shaft fractures. However, many
images are required to successfully perform the procedure, especially for
distal locking of the nail, resulting in cumulative radiation exposure to
the surgeon. Recently, computer-based technologies have been developed for
surgical navigation, enabling the surgeon to accurately track in real-time
the instruments, implants and patient anatomy during a procedure. This
paper reviews the principles and potential benefits of computer-aided
image-guided surgery for femoral shaft fracture, its indications, and its
pitfalls. The existing systems - commercially available and prototypes -
and the early clinical experience using this technique are also briefly
discussed.

Keywords: computer-assisted orthopaedic surgery, image-guided surgery,
femur fracture, intramedullary nailing.

Published in: 

Techniques in Orthopaedics, Special Issue on Computer-Aided Orthopaedic
Surgery, E. Hazan editor, Lippincott, Williams and Wilkens, Philadelphia,
USA, Vol. 18(2), 2003, pp 191--201.