Does Computer-assisted Surgery Improve Lag Screw Placement During Cephalomedullary Nailing of Intertrochanteric Hip Fractures?

CONCLUSION: CAS use is associated with a decrease in median TAD with less variation and fewer outliers during cephalomedullary nailing. Compared with the conventional technique, fewer outliers were noted with the CAS at the standard TAD threshold of 25 mm and a lower TAD threshold of 15 mm. Additional research is needed to determine the association of TAD variation and outliers on cut-out and to determine if there is any clinical value to the decrease in TAD variation and outliers noted here. The patient and surgical team are exposed to less radiation with the CAS compared with the conventional technique, but this difference is small and it is unclear if this benefit justifies CAS use. Incorporating CAS into the cephalomedullary nailing procedure is not associated with a change in operative time, so there are no costs or risks associated with increased operative time. More procedures would be needed to provide adequate power to better analyze the risk of lag screw cut-out, allowing a more complete understanding of the value of this technology compared with its cost. LEVEL OF EVIDENCE: Level III, therapeutic study. PMID: 32496321 [PubMed - as supplied by publisher]
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research