Zeitschrift für Orthopädie und Unfallchirurgie
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Comparative Study
[Intraoperative control of pedicle screw position using three-dimensional fluoroscopy. A prospective study in thoracolumbar fractures].
Screw misplacement affects the stability of the internal fixateur and may cause neurovascular complications. However, only a computer tomographic scan can show the exact position of the screws. This study was undertaken to assess the reliability of intraoperative three-dimensional imaging (3-D) to view screw positions. ⋯ Intraoperative imaging by 3-D fluoroscopy can predict very exactly the position of pedicle screws, especially, when a good scan quality is available and the spine section viewed is T 11-L 5. The scan offers the advantage of immediate correction of screw malposition. Thus, computer tomography to control pedicle screw position is dispensable.
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We report the case of an 82-year-old man with a pertrochanteric fracture of the hip and an avulsion of the lesser trochanter. During the third postoperative week after unproblematic correction with a gamma nail, a swelling of the proximal thigh occurred. Angiographs showed a false aneurysm of the deep femoral artery which was treated by suture.
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The aim of this study was to find the correct angle of the needle position for the epidural perineural injection at the lumbar spine without any help by imaging. ⋯ With some training it is possible to perform epidural-perineural injection for sciatica without the help of imaging.
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The aim of the study was to evaluate the application of a navigation system (Brainlab) to control length and torsion intraoperatively while nailing a femoral shaft fracture. ⋯ The application of a navigation system for repositioning of femoral shaft axes and controlling the length and torsion while nailing complex femoral shaft fractures is associated with some additional work. Nevertheless, in our study a relevant rotational deviation can be avoided by using the navigation system. To prove the advantage of the navigation system over the conventional technique, clinical studies with larger number of cases are necessary.