EVALUATION OF BONE FRAGMENTS REPOSITION ACCURACY IN PATIENT WITH CONDYLAR HEAD FRACTURES USING NAVIGATION GUIDES AND PATIENT-SPECIFIC FIXATORS

Abstract

One of the possible ways to increase the accuracy of bone fragments reposition in patients with condylar head fractures (CHF’s) is the use of computer diagnostics, virtual simulation of surgery, intraoperative navigation and CAD/CAM technology. The aim of present study was to evaluate the accura cy of repositioning of bone fragments in patient with CHF’s using specific fixators, navigation and repositioning guides in comparison with traditional methods of osteosynthesis according to multislice computed tomography. The patients were divided into two groups according to the type of surgery. At the first group patients were treated with the use of traditional technique and the second group – with the use of CAD/CAM technology. In all cases a 3D comparison was performed and deviations between the virtually planned and actual postoperative position of the condylar head were evaluated based on the CT data. The outer surfaces of both models (virtually planed and actual postoperative position) were selected for comparison. It was found that the average deviation between points at the 3D models obtained from postoperative CT and virtual plan was 1.02±0.56 mm at the first group and 1.05±0.46 mm in group with the use of CAD/CAM technology (p>0.05). The maximum deviations in the second group ranged from 1.4 to 4.2 average 3.3±0.87 mm. In the first group, this number were probably larger (U, p<0.05) average 5.05±2.5 mm (from 2.5 to 10.5). Conclusion. The use of CAD/CAM technologies in treatment patients with CHF’s can significantly increase the accuracy of bone fragments repositioning. The maximum deviation between the virtual plan and the obtained result according to CT data is reduced by an average of 40% compared to traditional methods of osteosynthesys.

Keywords

• condylar head fracture
• cad/cam technology
• surgical guides
• individualized plate.