Fluoro-navigation technology becomes more and more important in orthopaedic surgery. Because of preoperative alteration in fracture fragment orientation it is necessary to complete the fracture reduction before fluoroscopic image acquisition and surgery assisted with navigation. The advantages of the fluoro-navigation technology include minimal X-ray exposure, accurate positioning of implants, real time interactive quantitative data of the images, and minimally invasive surgery. With further development and improvement of both software and hardware, many operations, which require X-ray monitoring, can be conducted with the help of fluoro-navigation technology. Our past 4-year clinical experiences confirm the above advantages and its potential applications. As the technology of fluoro-navigation is still under improvement, further evaluation and validation is necessary to confirm its clinical values. In addition, fluoro-navigationsystems may play an important role in virtual surgical training and assessment. It may provide not only training opportunities to young surgeons but also an objective assessment system for evaluating proficiency of surgical techniques.

Objective To explore the application of fluoro-navigation in close reduction and fixation of pelvi-acetabular fractures. Methods After imaging reconstruction from plan X-rays and CT tomographs, close reduction and fixation of pelvi-acetabular fractures were conducted under fluoro-navigation based on the indications. If the reduction was found satisfactory, surgical planning was discussed together with the patients. Results No complications occurred among patients with pelvi-acetabular dislocation. Apart from few cases postoperative CT scan showed satisfactory crew fixation. Conclusion The current experiences suggest that the fluoro-navigation is indicated for fixation of pelvi-acetabular fractures with close reduction.

With the advancement in computer and imaging technologies, more and more surgical procedures can be performed with the help of the computer. This is especially true with the orthopaedic trauma surgery where the surgeons are working indirectly on the images, either acquired preoperatively or intraoperatively, to carry out fracture fixation procedures. The images can come from CT scan, intraoperative real-time fluoroscopy or endoscopy. The combination of computer and other information technologies in clinical practice is sure to be one of the major developments in the coming years. In this issue of the Chinese Journal of Orthopaedic Trauma, we will update you with the clinical applications of the real-time fluoro-navigation.

Objective To use 3D fluoro-images for reduction and fixation of articular and juxta-articular fractures. Methods Presurgical analysis was carried out based on standard plan X-rays and 3D fluoro-images. Stryker 3D Fluoro-navigation system was used for reduction and fixation of articular and juxta-articular fractures at the tibial plateau and distal tibia. Results A total of 11 tibial plateau fractures, 5 Pilon fractures and 1 femoral condyle fracture were treated. All the main fracture frangments were fixed via a small incision with canulated screws. Conclusion Navigation surgery based on the combined use of 3D fluoro-and CT-images is helpful in reducing the X-ray exposure in a minimally invasive surgery for articular fractures with acceptable accuracy.