Computer aided reduction and imaging.

Abstract

Reduction is one of the key procedures in orthopedic trauma surgery and has been acknowledged as one of the conditions for a good outcome in intraarticular and extra-articular fractures. The information available to the surgeon during the reduction maneuver can be divided into visual and tactile information. The optimal implementation of these parameters, combined with the surgeon's individual experience, will significantly affect the results of the operation. Anatomical regions where a limited direct view through the approach is supported by intraoperative imaging are intra-articular fractures of the elbow, forearm, acetabulum, proximal tibia, pilon, and hindfoot, and extra-articular fractures of the spine, pelvis, femur, and tibial shaft. Surgery in these regions is demanding since the approaches limit the visual control of the axes and also the anatomical reduction within the joint. Computer aided orthopedic surgery (CAOS) was introduced to increase the accuracy of selected procedures in orthopedic surgery. One of the most frequently applied applications is pedicle screw insertion in posterior spinal surgery. The current working group has identified computer aided reduction and implant positioning as an unresolved area of CAOS that would be highly relevant to the operative treatment of fractures. The development of tools for computer aided reduction is of major importance and is much desired by the orthopedic community. Such a reduction tool would be a significant step forward in the development of orthopedic trauma care. It would facilitate new procedures and new operations and also help to attain a completely new level with regard to what we can achieve in terms of minimal invasiveness and increased precision. The synergies of the expert group are deployed to develop the required software modules and hardware. Other areas of computer aided orthopedic surgery will certainly benefit from the integration of this technology as well.