Improved treatment of bone fractures with BrainLAB's image-guided VectorVision trauma

Charlottesville 14 September 2004Trauma injury is a common public health problem in the United States. Broken bones often result in painful surgery and long rehabilitation time causing disruptions to daily life, including long absences from work or school, and the inability to participate in recreational activities, including most sports. Although trauma injuries can occur year round, throughout the fall and winter, trauma surgeons regularly notice a significant increase in patients with broken bones. Most often those patients suffer from fractures of the femur, tibia, shoulder, upper arm, hip, or pelvis.


To enable surgeons to treat these fractures with the utmost precision, BrainLAB has developed a new software application for its proven navigation system called VectorVision trauma. With BrainLAB's new trauma software the radiation exposure to the surgical staff can be reduced considerably. At the beginning of the surgery, only a small number of x-ray shots are acquired and downloaded into the VectorVision system.

With these images and the trauma software, the surgeon can then navigate instruments such as screws and drills in real time. Since VectorVision is able to represent the movements of the bone fragments and the movements of the instruments being used in relation to the bone simultaneously, the need to take multiple x-ray images every few minutes is eliminated. Additionally, the surgeon can see precisely if he/she is reconstructing the bone correctly and if the instruments are guided to the desired target position.

Aaron Brad, a 17-year-old from Front Royal, Virginia, is one of the first patients to benefit from the new VectorVision trauma technology at the University of Virginia Health System. In January 2004, Aaron Brad was involved in a car accident and suffered multiple pelvic fractures and pulled his left leg out of its socket.

"His friends pulled him from the car and he suffered extensive bleeding", stated Jan Brad, Aaron's mother. "We knew the reputation of trauma surgeon Dr. Kahler, who worked out of the University of Virginia, and contacted him immediately about Aaron. The trauma Aaron suffered and resulting complications meant we knew we were in for a long recovery ahead."

Within days of the accident, Dr. Kahler operated on Aaron using VectorVision trauma. He spent one week in a rehabilitation facility and was then treated by Dr. Kahler on an outpatient basis for the next four months. By the end of May, Aaron was enrolled in tennis camp and looking forward to playing basketball for his church in the fall.

"Although Aaron's injuries could have been treated with the more standard, open surgical technique, I feel that his hospital stay was shortened significantly by our ability to do a virtual closed reduction and fixation using the BrainLAB system", stated Dr. David Kahler, Director of Orthopaedic Trauma for the University of Virginia Health System. "We made only three small incisions during surgery and precisely placed a large diameter screw following manipulation of his pelvis under virtual computer guidance. He had an excellent result, and we avoided many complications associated with this procedure. The BrainLAB system allowed us to store x-ray images of his pelvis for use during the procedure, rather than obtaining continuous images, and this spared both Aaron and the surgical team from excessive radiation exposure."

Until now, most trauma surgeons treat fractures in the Operating Room with the help of an x-ray device. However, for the surgeon to be able to verify if he is joining the bone accurately and to see where his instruments are in relation to the bone he is treating, this x-ray device needs to be almost constantly emitting x-rays in order to provide the most up to date images. As a result, the radiation exposure for the patient and also for the clinical team, who sometimes perform these procedures several times a day, is very high. With VectorVision trauma that exposure can be considerably reduced.

BrainLAB, a privately held company headquartered in Munich, Germany, was founded in 1989 and is specialized in the development, manufacture, and marketing of medical technology for radiosurgery and radiotherapy, orthopaedics, neurosurgery, and ENT. Among the products developed by BrainLAB are software and hardware components for image-guided surgery, components for linear accelerators in radiotherapy as well as integrated systems for stereotactic radiosurgery.

With about 1300 systems installed in over 50 countries, BrainLAB is among the market leaders in image-guided medical technology. BrainLAB now works with distributors in over 70 countries and has 15 offices across Europe, Asia, North and South America. More company information is available in the VMW August 2004 article Hip replacement patients benefit from routine precision in BrainLAB's new CT-free hip navigation software

Leslie Versweyveld

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