Current concepts and applications of computer navigation in orthopedic trauma surgery

Navigation has become widely integrated into regular endoprosthetic procedures, but clinical use of navigation systems in orthopaedic trauma has only been implemented in a few indications. Navigation systems enable an accuracy of 1 mm or 1 degree. Navigation can achieve higher precision when it is combined with different imaging modalities, including preoperative computer tomography (CT), intraoperative CT, two-dimensional fluoroscopy, and, recently, intraoperative three-dimensional fluoroscopy. The precision of the navigation system can be influenced by the surgeon as well as by the camera system, type of reference marker, and the registration process. Recent developments in orthopedic trauma navigation allow for bilateral femoral anteversion measurements, noninvasive registration of an uninjured thigh, and intraoperative three-dimensional fluoroscopy-based pedicle screw placement. Although the use of navigation has provided initial positive results in trauma care, prospective clinical studies remain to be performed.

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