Fracture reduction and screw position after 3D-navigated and conventional fluoroscopy-assisted percutaneous management of acetabular fractures: a retrospective comparative study.

BACKGROUND: Navigational techniques in orthopaedic trauma surgery have developed over the last years leaving the question of really improving quality of treatment. Especially in marginal surgical indications, their benefit has to be evident. The aim of this study was to compare reduction and screw position following 3D-navigated and conventional percutaneous screw fixation of acetabular fractures. The study hypothesis postulated that better fracture reduction and better screw position are obtained with 3D navigation.

MATERIALS AND METHODS: Preoperative and postoperative CT scans of 37 acetabular fractures treated by percutaneous screw fixation (24 3D-navigated, 13 conventional) were evaluated. Differences in pre- and postoperative fracture gaps and steps were compared in all reconstructions as well as the screw position relative to the joint and the fracture.

RESULTS: The differences in fracture gaps and fracture steps with and without 3D navigation were not significantly different. Distance of the screw from the joint line, angle difference between screw and ideal angle relative to the fracture line, length of the possible corridor used and position of the screw thread did not show any significant differences.

CONCLUSION: Comparison of 3D-navigated and conventional percutaneous surgery of acetabular fractures on the basis of pre- and postoperative CTs revealed no significant differences in terms of fracture reduction and screw position.