Computer-assisted LISS plate osteosynthesis of proximal tibia fractures: Feasibility study and first clinical results

Figures & data

Figure 1. Acquisition of fluoroscopic images.

Figure 2. Alignment mode for precise placement of the image intensifier.

Figure 3. Virtual three-dimensional space created from two-dimensional X-ray projections.

Figure 4. User interface with visualization of X-ray dynamization and three-dimensional representation of a fracture fixation plate.

Figure 5. Intraoperative application showing navigated reduction and osteosynthesis.

Figure 6. Corresponding visualization on the monitor screen.

Table 1.  Clinical information for patients treated with the prototype system.

	Patient 1	Patient 2	Patient 3 (right)	Patient 3 (left)
Age	38	61	49	49
Gender	M	M	M	M
Date of operation	June 29, 2001	August 14, 2001	August 28, 2001	August 28, 2001
Diagnosis	Proximal tibia fracture, AO C1, soft tissue damage (third degree), local soft tissue transfer (local flap) 6 weeks after accident and external fixator	Proximal tibia fracture, AO C1 remaining instability and varus deformity after UTN 4 months before (extern)	Proximal tibia fracture, AO C3 2 Stage fracture, soft tissue damage (second degree), primary external fixator on August 9, 2001	Proximal tibia fracture, AO Cl primary external fixator on August 9, 2001
Type of OR	Removal of external fixator, 13 holes LISS	Removal of UTN, 13 holes LISS	Change of procedure after removal of external fixator, 13 holes LISS	Change of procedure after removal of external fixator, 13 holes LISS
OR time (cut–suture)	105 mm	120 min	75 min	76 min
Blood loss	250 ml	300 ml	180 ml	160 ml
Radiation time	1.0 min	0.8 min	0.3 min	0.25 min
Complications	No	No	No	No
Follow-up	Uneventful healing Documented in 6, 12,  and 18 months follow-up	Uneventful healing Documented in 6, 12,  and 18 months follow-up	Uneventful healing Documented in 6, 12,  and 18 months follow-up	Uneventful healing Documented in 6, 12,  and 18 months follow-up