Comparison of intraoperative flat panel imaging and postoperative plain radiography for the detection of intraarticular screw displacement in volar distal radius plate ostheosynthesis
| Autor: | L. Mahlke, D. Varoga, S. Lippross, Thilo Wedel, Matthias Weuster, A. Seekamp, L. Menzdorf, D. Zorenkov, H. Bolte, M. Müller, J. Borggrefe, W. Worms |
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| Rok vydání: | 2015 |
| Předmět: |
Wrist Joint
medicine.medical_specialty Cone beam computed tomography Radiography Flat panel detector Bone Screws Sensitivity and Specificity Fracture Fixation Internal Imaging Three-Dimensional Cadaver Bone plate medicine Humans Fluoroscopy Orthopedics and Sports Medicine Displacement (orthopedic surgery) Postoperative Period Intraoperative fluoroscopy Screw misplacement Intraoperative Care medicine.diagnostic_test business.industry Gold standard (test) Radius fracture Cone-Beam Computed Tomography Surgery Radius Intraarticular screw Radius Fractures Tomography X-Ray Computed business Bone Plates |
| Zdroj: | Orthopaedics & Traumatology: Surgery & Research. 101:913-917 |
| ISSN: | 1877-0568 |
| DOI: | 10.1016/j.otsr.2015.07.023 |
| Popis: | Objectives To investigate if intraoperative 3D flat panel imaging improves the detection of radiocarpal intraarticular screw misplacement (RCSM) in comparison to standard postoperative x-ray. Methods In a study on cadaver specimens, we evaluated the sensitivity and specificity to detect RCSM using X-ray, intraoperative 3D-fluoroscopy as well as the digital volume tomography. The gold standard reference was computed tomography. Results Sensitivity for the detection of RCSM for X-ray was 58% and specificity 88%. For DVT, the sensitivity to detect RCSM was 88% and the specificity 53%. For 3D-fluoroscopy, the sensitivity for RCSM was 68% and specificity 95%. When combining the methods, the best performance was found, when combining the two intraoperative imaging methods, with a resulting sensitivity of 88% and a specificity of 73%. Conclusions Intraoperative 3D fluoroscopy and digital volume tomography appear to be at least as sensitive and specific to detect RCSM than the regular postoperative radiography in two planes. However, especially discrete screw misplacements can be missed with either method. Level of evidence Level IV. Diagnostic device study. |
| Databáze: | OpenAIRE |
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