When using computer assisted surgery, the reduction (and fixation if necessary) is performed according to standard procedures as described in the AO Surgery Reference. It should be considered an adjunct to surgical treatment.
Computer assisted surgery in treating fractures allows virtual preoperative planning of the desired reconstruction using preoperative CT scans and appropriate software.
Intraoperative imaging combined with image fusion of preoperative and intraoperative CT scans, and the virtual plan allows verification of proper reduction.
When dealing with complex fractures, intraoperative navigation is extremely useful to assist in reducing the zygoma and properly reconstructing the orbital walls. Often intraoperative corrections of fragment reduction and orbital wall reconstruction are necessary. Rather than performing repeated intraoperative CT scans, radiation dose-free intraoperative navigation provides intraoperative guidance to the virtually planned reconstruction.
In complex orbital floor fractures radiopaque material for orbital wall reconstruction can easily be visualized on imaging allowing intraoperative or postoperative verification of proper reconstruction.
With this technique, insufficient fracture reduction can be can be identified and corrected, eliminating the need for secondary procedures which may be necessary if only postoperative imaging is performed.
Intraoperative imaging requires an additional 10-15 min.