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Eignung der computerassistierten Femurmarknagelung zur Kontrolle von Torsion und Länge

Systematischer Literaturüberblick zu klinischen Studien

Suitability of computer-assisted femoral intramedullary nailing for control of torsion and length

Systematic review of clinical studies

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Zusammenfassung

Hintergrund

Die computerassistierte Femurmarknagelung zeigte in experimentellen Studien sehr aussichtsvolle Ergebnisse. Ziel der vorliegenden Studie war es, die computerassistierte Femurmarknagelung auf der Basis vorhandener klinischer Studien zu evaluieren und zu bewerten.

Material und Methoden

Es erfolgte die systematische Analyse sämtlicher vorhandener Literatur mit klinischer Anwendung der computerassistierten Femurmarknagelung (PubMed, Cochrane Library und Embase). Publizierte Studien bis zum Mai 2017 wurden eingeschlossen.

Ergebnisse

Es konnten insgesamt 3 klinische Studien analysiert werden. Unter Verwendung der computerassistierten Femurmarknagelung war in allen Studien ein relevanter Anstieg der Operations- und intraoperativen Strahlungszeit zu verzeichnen. Das klinische Ergebnis in Bezug auf Femurtorsion und -länge war tendenziell besser zugunsten der computerassistierten Versorgung, jedoch waren die Ergebnisse sehr heterogen.

Schlussfolgerung

Die vorliegende Analyse konnte zeigen, dass der erfolgreiche klinische Einsatz der computerassistierten Femurmarknagelung möglich ist. Jedoch kommt es zu einer relevanten Verlängerung der Operationszeit und zu einer höheren Strahlenbelastung. In Bezug auf das postoperative Ergebnis hinsichtlich Femurtorsion und -länge fanden sich sehr heterogene Ergebnisse. Weitere vergleichende Studien werden in Zukunft benötigt.

Abstract

Background

Despite promising results in experimental studies, computer-assisted femoral intramedullary nailing has not become established in the clinical practice for most orthopedic surgeons. The purpose of this study was to evaluate the advantages and disadvantages of computer-assisted reduction and nailing of femoral fractures as reported in clinical studies.

Material and methods

A systematic analysis of the available literature on the clinical application of computer-assisted femoral intramedullary nailing (Pubmed, Cochrane library and Embase) was carried out. Studies published up to May 2017 were included.

Results

A total of three articles were included in this meta-analysis. All studies showed a relevant increase in total operating time and radiation exposure time with the use of computer-assisted femoral intramedullary nailing. The clinical results for computer-assisted nailing with respect to femoral torsion and length tended to be slightly better but the results were very heterogeneous.

Conclusion

Our analysis could show that computer-assisted femoral intramedullary nailing is clinically feasible but the operative and fluoroscopy time needed are high and the reported postoperative results for femoral length and torsion were very heterogeneous. Further comparative studies are needed in the future.

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Authors and Affiliations

  1. Unfallchirurgische Klinik, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    Emmanouil Liodakis,  Christian Krettek &  Nael Hawi

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  1. Emmanouil Liodakis
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  2. Christian Krettek
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  3. Nael Hawi
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Correspondence to Emmanouil Liodakis.

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E. Liodakis, C. Krettek und N. Hawi geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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C. Krettek, Hannover

E. Liodakis, Hannover

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Liodakis, E., Krettek, C. & Hawi, N. Eignung der computerassistierten Femurmarknagelung zur Kontrolle von Torsion und Länge. Unfallchirurg 121, 182–190 (2018). https://doi.org/10.1007/s00113-017-0441-z

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