Computer-Assisted Image-Guided Intramedullary Nailing of Femoral Shaft Fractures

Closed reduction and intramedullary nailing under x-ray fluoroscopy is the current treatment of choice for femoral shaft fractures. However, many images are required to successfully perform the procedure, especially for distal locking of the nail, resulting in cumulative radiation exposure to the surgeon. Recently, computer-based technologies have been developed for surgical navigation, enabling the surgeon to accurately track in real-time the instruments, implants, and patient anatomy during a procedure. This article reviews the principles and potential benefits of computer-aided image-guided surgery for femoral shaft fracture, its indications, and its piffalls. The existing systems, commercially available and prototypes, and the early clinical experience using this technique are also briefly discussed.