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Intraoperative fluoroscopy to evaluate fracture reduction and hardware placement during acetabular surgery
B L Norris1, D H Hahn, M J Bosse
1Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina 28262, USA.
Objectives:
To evaluate use of intraoperative fluoroscopy during acetabular surgery to determine fracture reduction and accurate placement of screws.
Design:
Retrospective.
Setting:
Level I trauma center.
Participants:
Thirty patients with thirty-two acetabular fractures.
Intervention:
Patients were evaluated with fluoroscopy during surgery to assess fracture reduction and screw placement. Anterior-posterior (AP), oblique, and lateral pelvic fluoroscopic images were obtained intraoperatively. Postoperative radiographs were used to verify fluoroscopic findings; computed tomography (CT) scans were used as the control to assess intraarticular screw placement.
Main Outcome Measurements:
Radiographic and clinical assessment of fracture reduction and screw placement.
Results:
Intraoperative fluoroscopy confirmed the extra-articular position of all screws evaluated. Postoperative CT scans confirmed the extra-articular placement of all screws assessed by fluoroscopy. Quality of reduction using intraoperative fluoroscopic images had a 100 percent correlation with reduction on final radiographs. One patient, with two screws placed without fluoroscopic evaluation, had intra-articular placement requiring revision surgery.
Conclusions:
Intraoperative fluoroscopy is effective in evaluating both acetabular fracture reduction and hardware placement.