NAGIVATION IN TRAUMATOLOGY

Summary

INTRODUCTION:
Navigation in traumatology presents a new technique, which enables to carry out a wide range of osteosyntheses with a reduced use of the X-ray apparatus in the course of the operation. Its principle is based upon a transfer of input X-ray images into the navigating computer, which consequently monitors the movement of bone fragments during repositioning, as well as some instruments in the course of osteosynthesis.

METHODS:
Navigation is mainly used with certain osteosyntheses in the area of pelvis, femur and tibia. First, a set of special sensors is inserted into the bone; basic X-ray projections of the fracture follow, eventually including also the proximal and distal ends of the bone. These images are consequently downloaded in the navigating computer. The use of navigation enables repositioning of the fracture and insertion of osteosynthetic material.

CLINICAL EXPERIENCE:
In our centre, we have been using the navigation in traumatology since 2006. Having accomplished a set of initial osteosynthesis using a borrowed system, we decided to purchase the navigation system in 2007; since then we have been carrying some osteosyntheses of the pelvis, femur and tibia under the navigation system. Fractures in the area of SI spine, diaphysis, tibia and femur prove to be the most suitable. With the increasing amount of experience, the time required for the initial insertion of sensors and downloading the fracture images is shortening, the radiation time during the operation is also reduced.

CONCLUSION:
Navigation enables a more precise osteosynthesis of some types of fractures, especially with the monitoring of a rotation deviation and the length in fractures of long bones. It siguces the impact of ionizing radiation upon the patient and the staff at operating theatre. A good management of the operation technique and preparation stage results in shortening of the operation time, mainly due to the reduction of repeated X-ray projections during the repositioning of the fracture and securing of the nailing.

KEY WORDS:
computer navigation, osteosynthesis.