[Intraoperative 3D C-arm imaging. State of the art]

Area of Science:

• Orthopedic surgery
• Medical imaging technology

Background:

• Mobile C-arms with 3D imaging capabilities offer intraoperative visualization of complex anatomical structures.
• Osteosynthesis procedures often require precise fracture reduction and implant positioning.

Purpose of the Study:

• To evaluate the utility of intraoperative 3D imaging in assessing and improving fracture reduction and implant positioning during osteosynthesis.
• To determine the frequency and anatomical locations where intraoperative adjustments are most needed.

Main Methods:

• A retrospective analysis of 1,841 intraoperative control scans performed over 8 years following osteosynthesis.
• Data collected included the area of surgery, number of intraoperative adjustments, and correlation with surgical site.

Main Results:

• The majority of scans were for calcaneus (20.5%) and upper ankle joint (13.2%) fractures.
• Intraoperative improvements in reduction or implant position were achieved in 21.5% of cases.
• The highest rates of intraoperative revision were observed in calcaneus (40.3%), upper ankle joint (30.9%), and distal tibia (29%) osteosynthesis.

Conclusions:

• Intraoperative 3D imaging is a valuable tool for identifying and correcting suboptimal fracture reduction and implant placement.
• The need for intraoperative revision is common, particularly in complex joint fractures.
• This technology can enhance the quality of osteosynthesis in challenging anatomical areas.