Use of indocyanine green fluorescent dye video angiography in orthopaedic trauma: a pilot study

There is no literature describing the use of indocyanine green angiography in orthopaedic trauma. This study describes four cases in which the novel application of laser-assisted indocyanine green angiography (LA-ICGA) was used to assist surgical decision making in orthopaedic trauma. It is an observational, retrospective case series of four primary trauma patients in which LA-ICGA was used to qualitatively evaluate tissue perfusion in the intraoperative setting. Poor perfusion on LA-ICGA was associated with negative clinical outcome, including progression to necrosis or amputation. LA-ICGA provides an assessment of soft tissue perfusion that may be correlated to tissue prognosis. It is safe for patient use, can be used at the bedside or intraoperatively, and allows for multiple repeat assessments within a short period. This technology holds promise for more widespread use in orthopaedic trauma, especially in controversial fields, such as defining the threshold for amputation versus reconstruction.