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2007 | 2 | 4 | 392-403

Article title

Current concepts and applications of computer navigation in orthopedic trauma surgery


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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.










Physical description


1 - 12 - 2007
1 - 12 - 2007


  • Trauma Department, Hannover Medical School, 30625, Germany
  • Trauma Department, Hannover Medical School, 30625, Germany
  • Trauma Department, Hannover Medical School, 30625, Germany
  • Trauma Department, Hannover Medical School, 30625, Germany
  • Trauma Department, Hannover Medical School, 30625, Germany


  • [1] T. Hüfner, D. Kendoff, M. Citak, J. Geerling and C. Krettek: “Precision in orthopaedic computer navigation”, Der Orthopade, Vol. 35, (2006), pp. 1043–55. http://dx.doi.org/10.1007/s00132-006-0995-x[Crossref]
  • [2] L.P. Amiot, K. Lang, M. Putzier, H. Zippel and H. Labelle: “Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine”, Spine, Vol. 25, (2000), pp. 606–14. http://dx.doi.org/10.1097/00007632-200003010-00012[Crossref]
  • [3] T. Laine, D. Schlenzka, K. Makitalo, K. Tallroth, L.P. Nolte and H. Visarius: “Improved accuracy of pedicle screw insertion with computer-assisted surgery. A prospective clinical trial of 30 patients”, Spine, Vol. 22, (1997), pp. 1254–1258. http://dx.doi.org/10.1097/00007632-199706010-00018[Crossref]
  • [4] A. Weidner, M. Wahler, S.T. Chiu and C.G. Ullrich: “Modification of C1–C2 transarticular screw fixation by image-guided surgery”, Spine, Vol. 25, (2000), pp. 2668–2673. http://dx.doi.org/10.1097/00007632-200010150-00020[Crossref]
  • [5] S. Lavallee, P. Sautot, J. Troccaz, P. Cinquin and P. Merloz: “Computer-assisted spine surgery: a technique for accurate transpedicular screw fixation using CT data and a 3-D optical localizer”, Journal of image guided surgery, Vol. 1, (1995), pp. 65–73. http://dx.doi.org/10.1002/(SICI)1522-712X(1995)1:1<65::AID-IGS10>3.0.CO;2-7[Crossref]
  • [6] L.P. Nolt, L. Zamorano, H. Visarius, U. Berlemann, F. Langlotz, E. Arm and O. Schwarzenbach: “Clinical evaluation of a system for precision enhancement in spine surgery”, Clin Biomech (Bristol, Avon), Vol. 10, (1995), pp. 293–303. http://dx.doi.org/10.1016/0268-0033(95)00004-5[Crossref]
  • [7] T. Hüfner, J. Geerling, A. Gänsslen, D. Kendoff, C. Citak, P. Grützner and C. Krettek: “Computer-assisted surgery for pelvic injuries”, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, Vol. 75, (2004), pp. 961–966. [Crossref]
  • [8] T. Hüfner, J. Geerling, M. Kfuri Jr., A. Gänsslen, M. Citak, T. Kirchhoff, A.H. Sott and C. Krettek: “Computer assisted pelvic surgery: registration based on a modified external fixator”, Comput Aided Surg, Vol. 8, (2003), pp. 192–197. [Crossref][PubMed]
  • [9] D. Kendoff, T. Hüfner, M. Citak, J. Geerling, E. Mössinger, L. Bastian and C. Krettek: “Navigated Iso-C3D-based percutaneous osteoid osteoma resection: a preliminary clinical report”, Comput Aided Surg, Vol. 10, (2005), pp. 157–163. http://dx.doi.org/10.1080/10929080500229868[Crossref]
  • [10] U. Stöckle, B. Konig, M. Dahne, M. Raschke and N.P. Haas: “Computer assisted pelvic and acetabular surgery. Clinical experiences and indications”, Unfallchirurg, Vol. 105, (2002), pp. 886–892. http://dx.doi.org/10.1007/s00113-002-0438-z[Crossref]
  • [11] H. Bäthis, L. Perlick, C. Luring, T. Kalteis and J. Grifka: “CT-based and CTfree navigation in knee prosthesis implantation. Results of a prospective study”, Unfallchirurg, Vol. 106, (2003), pp. 935–940.
  • [12] F. Langlotz, L.P. Nolte and M. Tannast: “The foundations of computer assisted surgery”, Der Orthopade, Vol. 35, (2006), pp. 1032–1037. http://dx.doi.org/10.1007/s00132-006-0993-z[Crossref]
  • [13] M. Citak, T. Hüfner, J. Geerling, M. Kfuri Jr., A. Gänsslen, V. Look, D. Kendoff and C. Krettek: “Navigated percutaneous pelvic sacroiliac screw fixation: experimental comparison of accuracy between fluoroscopy and Iso-C3D navigation”, Comput Aided Surg, Vol. 11, (2006), pp. 209–213. http://dx.doi.org/10.1080/10929080600890015[Crossref]
  • [14] C. Fink, R.E. Rosenberger, R.J. Bale, M. Rieger, W. Hackl, K.P. Benedetto, K.H. Kunzel and C. Hoser: “Computer-assisted retrograde drilling of osteochondral lesions of the talus”, Der Orthopade, Vol. 30, (2001), pp. 59–65. http://dx.doi.org/10.1007/s001320050574[Crossref]
  • [15] T. Hüfner, M. Kfuri Jr., D. Kendoff, M. Richter, J. Geerling and C. Krettek: “Navigated osteosynthesis of the proximal femur. An experimental study”, Unfallchirurg, Vol. 106, (2003), pp. 975–979.
  • [16] D. Kendoff, J. Geerling, L. Mahlke, M. Citak, M. Kfuri Jr., T. Hüfner and C. Krettek: “Navigated Iso-C(3D)-based drilling of a osteochondral lesion of the talus”, Unfallchirurg, Vol. 106, (2003), pp. 963–967.
  • [17] D. Kendoff, T. Hüfner, M. Citak, C. Maier, F. Wesemeier, A. Pearle and C. Krettek: “A new parallel drill guide for navigating femoral neck screw placement: Development and evaluation”, Unfallchirurg, Vol. 109, (2006), pp. 875–880. http://dx.doi.org/10.1007/s00113-006-1142-1[Crossref]
  • [18] M. Citak, D. Kendoff, M. Kfuri Jr., A. Pearle, C. Krettek and T. Hüfner: “Accuracy analysis of Iso-C3D versus fluoroscopy-based navigated retrograde drilling of osteochondral lesions: A PILOT STUDY”, J Bone Joint Surg Br, Vol. 89, (2007), pp.323–326. http://dx.doi.org/10.1302/0301-620X.89B3.18424[Crossref][WoS]
  • [19] J.A. Ohnsorge, E. Schkommodau, D.C. Wirtz, J.E. Wildberger, A. Prescher and C.H. Siebert: “Accuracy of fluoroscopically navigated drilling procedures at the hip”, Zeitschrift fur Orthopadie und ihre Grenzgebiete, Vol. 141, (2003), pp. 112–119. http://dx.doi.org/10.1055/s-2003-37305[Crossref]
  • [20] D. Kendoff, M. Citak, M.J. Gardner, T. Gösling, C. Krettek and T. Hüfner: “Navigated Femoral Nailing Using Non Invasive Registration of the Contralateral Intact Femur to Restore Anteversion-Technique and Clinical Use”, J Ortho Trauma, In Press, (2007). [WoS]
  • [21] S. Hankemeier, G. Zheng, G. Wang, D. Kendoff, J. Zeichen, T. Hüfner and C. Krettek: “Navigated open wedge high tibia osteotomy: Advantages and disadvantages in comparison to the conventional technique in a cadaver study”, Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 14, (2006), pp. 917–921. http://dx.doi.org/10.1007/s00167-006-0035-8[Crossref]
  • [22] J.Y. Jenny, C. Boeri, F. Picard, F. Leitner: “Reproducibility of intra-operative measurement of the mechanical axes of the lower limb during total knee replacement with a non-image-based navigation system”, Comput Aided Surg, Vol. 9, (2004), pp. 161–165. http://dx.doi.org/10.1080/10929080500095517[Crossref]
  • [23] P. Keppler, F. Gebhard, P.A. Grützner, G. Wang, G. Zheng, T. Hüfner, S. Hankemeier, L.P. Nolte: “Computer aided high tibial open wedge osteotomy”, Injury, Vol. 35,Suppl 1, (2004), pp. S-A68–A78. [Crossref]
  • [24] D. Kendoff, A. Bogojevic, M. Citak, M. Citak, C. Maier, G. Maier, C. Krettek and T. Hufner: “Experimental validation of noninvasive referencing in navigated procedures on long bones”, J Orthop Res, Vol. 25, (2007), pp.201–207. http://dx.doi.org/10.1002/jor.20318[Crossref][WoS]
  • [25] D. Kotsianos, C. Rock, E. Euler, S. Wirth, U. Linsenmaier, R. Brandl, W. Mutschler and K.J. Pfeifer: “3-D imaging with a mobile surgical image enhancement equipment (ISO-C-3D). Initial examples of fracture diagnosis of peripheral joints in comparison with spiral CT and conventional radiography”, Unfallchirurg, Vol. 104, (2001), pp. 834–838. http://dx.doi.org/10.1007/s001130170054[Crossref]
  • [26] D. Kotsianos, C. Rock, S. Wirth, U. Linsenmaier, R. Brandl, T. Fischer, E. Euler, W. Mutschler, K.J. Pfeifer and M. Reiser: “Detection of tibial condylar fractures using 3D imaging with a mobile image amplifier (Siemens ISO-C-3D): Comparison with plain films and spiral CT”, Rofo, Vol. 174, (2002), pp. 82–87.
  • [27] R. Khadem, C.C. Yeh, M. Sadeghi-Tehrani, M.R. Bax, J.A. Johnson JA, J.N. Welch, E.P. Wilkinson and R. Shahidi: “Comparative tracking error analysis of five different optical tracking systems”, Comput Aided Surg, Vol. 5, (2000), pp. 98–107. http://dx.doi.org/10.1002/1097-0150(2000)5:2<98::AID-IGS4>3.0.CO;2-H[Crossref]
  • [28] Q. Li, L. Zamorano, Z. Jiang, J.X. Gong, A. Pandya, R. Perez and F. Diaz: “Effect of optical digitizer selection on the application accuracy of a surgical localization system-a quantitative comparison between the OPTOTRAK and flashpoint tracking systems”, Comput Aided Surg, Vol. 4, (1999), pp. 314–321. http://dx.doi.org/10.1002/(SICI)1097-0150(1999)4:6<314::AID-IGS3>3.0.CO;2-G[Crossref]
  • [29] E. Mayr, J.L. de la Barrera, G. Eller, C. Bach and M. Nogler: “The effect of fixation and location on the stability of the markers in navigated total hip arthroplasty: a cadaver study”, J Bone Joint Surg Br, Vol. 88, (2006), pp. 168–172. http://dx.doi.org/10.1302/0301-620X.88B2.17257[Crossref]
  • [30] W.M. Mihalko, T. Duquin, J.R. Axelrod, M. Bayers-Thering and K.A. Krackow: “Effect of one-and two-pin reference anchoring systems on marker stability during total knee arthroplasty computer navigation”, Comput Aided Surg, Vol. 11, (2006), pp. 93–98. http://dx.doi.org/10.1080/10929080600668122[Crossref]
  • [31] M. Citak, D. Kendoff, T. Board, C. Krettek and T. Hüfner: “Stability of different reference marker systems in computer aided surgerey”, Comput Aided Surg, in Press, (2007).
  • [32] P. Keppler, W. Strecker and L. Kinzl: “Analysis of leg geometry-standard techniques and normal values”, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, Vol. 69, (1998), pp. 1141–1152. [Crossref]

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