Rotational control by fluoroscopic CAS of diaphyseal fractures of the lower limbs

摘要

Introduction: Intramedullary (IM) nailing has become the most performed method of treatment for diaphyseal fracture of femur and tibia in adults because it is safe, less invasive than a plate, gives excellent healing of the fracture and fast recovery, it produces cometic scars. The most critical point of IM is the control of the rotational malalignment compared to the plate fixation method, which is under direct sight control, and the only objective exam to evaluate the degree of the deformities is a CT scan comparing both bone segments, affected and healthy one [1,2,3,4,5,6,7,8,9,1 0,13,14]. The fluoroscopic navigation might be the solution to this issue as well as might decrease the intraoperative radiation exposure compared to standard fluoroscopic technique.[2,11,14]. Methods: From December 2005 to December 2006 17 fractures , 8 femurs ( AO Class.:32-A3; 32-B2) and 9 tibia (AO Class.: 42-A3; 42-A2 ), have been undergone to surgical reduction and fixation by antero- and retrograde nails ( Stryker~R T2) using the Brainlab navigation system "Vector-Vision~R - Compact", software VVTrauma 2,5~R linked to the GE -OEC 9800 Plus 12 ", a 2D fluoroscope. The population is: 10 males, 7 females; mean age 44, 3 years (min 24-max 73); mean follow up 9 months.