Comparison of Intraoperative C-Arm Fluoroscopy to Postoperative Radiographs in Operative Fracture Fixation.

Area of Science:

• Orthopaedic Surgery
• Radiology
• Medical Imaging

Background:

• Intraoperative imaging is crucial for immediate assessment during fracture repair.
• Postoperative imaging confirms fixation and guides subsequent patient management.
• Evaluating the comparative utility of different imaging modalities is essential for optimizing surgical outcomes.

Purpose of the Study:

• To compare intraoperative C-arm images with postoperative plain film radiographs.
• To assess the utility of each imaging type in evaluating fracture fixation.
• To determine the impact of imaging on postoperative management decisions.

Main Methods:

• Analysis of intraoperative C-arm images and postoperative plain film radiographs for various fractures.
• Comparison of image adequacy, quality, reduction, and fixation by two orthopaedic surgeons.
• Identification of factors influencing changes in postoperative treatment plans.

Main Results:

• Postoperative radiographs indicated a need for treatment plan modification in 8.2% of cases.
• Fracture gap, rotation, and angulation were the strongest predictors for recommended treatment changes.
• Variability exists in how well intraoperative and postoperative images reflect fracture characteristics.

Conclusions:

• Postoperative plain film radiographs provide critical information influencing patient management.
• Both imaging modalities have roles, but postoperative X-rays offer distinct advantages for treatment adjustments.
• Further research may clarify the optimal use of each imaging technique for fracture assessment.