Background: Accurate placement of cannulated screws is essential to
ensure secure fixation of femoral neck fractures. We compared computerized
navigation and conventional fluoroscopy with regard to the accuracy of screw
placement for the fixation of femoral neck fractures.
Methods: We retrospectively compared two groups of twenty
consecutive patients with a femoral neck fracture who underwent internal
fixation with three cannulated screws. Computer-based navigation was used to
guide screw placement in one group, and conventional fluoroscopy was used in
the other group. Radiographic evaluation included the measurement of screw
parallelism and spread, the calibrated distance from the lesser trochanter,
and joint penetration. The follow-up period was two years. The rates of
complications in both groups were evaluated.
Results: The navigation-assisted group had better screw parallelism
and greater spread of the screws. There was a tendency for fewer reoperations
and significantly fewer overall complications in the patients in whom
computerized navigation was used (p < 0.018).
Conclusions: Computerized navigation improves the accuracy of
cannulated screw placement in the internal fixation of femoral neck fractures.
It may provide better mechanical stability and improved fracture outcome.
Level of Evidence: Therapeutic Level III. See
Instructions to Authors for a complete description of levels of evidence.