Does intraoperative fluoroscopic 3D imaging provide extra information for fracture surgery?
| Autor: | D. Th. Ubbink, J.C. Goslings, Robert Haverlag, B. Carelsen, Jan S. K. Luitse |
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| Přispěvatelé: | Biomedical Engineering and Physics, Surgery, Patient Care Support, Other Research, Emergency Department, Amsterdam Movement Sciences |
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_treatment Cohort Studies Fracture Fixation Internal Fractures Bone Elbow Joint Fluoroscopy Orthopedics and Sports Medicine Ankle Injuries Arthrography Child Aged 80 and over Fracture Healing Observer Variation medicine.diagnostic_test General Medicine Middle Aged Wrist Injuries Treatment Outcome Radiological weapon Shoulder Fractures Female Radiology Adult medicine.medical_specialty Adolescent Risk Assessment Sensitivity and Specificity Statistics Nonparametric Young Adult Imaging Three-Dimensional Monitoring Intraoperative medicine Humans New device Reduction (orthopedic surgery) Aged Probability business.industry Recovery of Function Surgery Extremity fractures Orthopedic surgery Fracture (geology) Joints business Elbow Injuries Trauma surgery Follow-Up Studies |
| Zdroj: | Archives of orthopaedic and trauma surgery, 128(12), 1419-1424. J.F. Bergmann |
| ISSN: | 1434-3916 0936-8051 |
| Popis: | Fracture surgery of the extremities using 2D fluoroscopy frequently fails to detect the suboptimal positioning of implants and joint incongruities. The use of intraoperative 3D-rotational X-ray (3D-RX) imaging with a new X-ray device potentially reveals these failures. We compared 50 intraoperative (2D) results of surgery and certainty about the effectiveness of different aspects of fracture reduction as interpreted from conventional (2D) methods versus intraoperative 3D-RX in 42 distal extremity fractures by means of a surgery questionnaire. In addition, we investigated the need for revision surgery based on postoperative radiological findings in 81 patients. After fracture reduction, just before a 3D-RX scan, the surgeon preoperatively assessed the result of surgery. Three months after surgery, the 3D-RX scan was judged by three experienced surgeons independently. Intraoperative 3D-RX showed significantly more information as to screw positioning and rotation of the fracture reduction than the conventional method (p < 0.005). None of the 81 patients in whom 3D-RX was performed needed surgical revision based on postoperative radiological examinations. Intraoperative 3D-RX with this new device scanning offers additional information about extremity fracture reduction as compared to conventional intraoperative 2D imaging, and may reduce the need for revision surgery. The value of 3D-RX on functional outcomes still needs to be assessed. |
| Databáze: | OpenAIRE |
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