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Limb position affects intraoperative assessment of condylar width
Douglass W Tucker1, Michael J Chen2, Akhil Reddy3
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Summary
Knee flexion during fluoroscopic imaging can underestimate condylar width measurements by approximately 2 mm. Rotation of the knee did not significantly impact condylar width assessment in this study.
Area of Science:
- Orthopedic surgery
- Radiology
- Biomedical imaging
Background:
- Accurate intraoperative assessment of condylar widening is crucial for tibial plateau fracture management.
- Fluoroscopic imaging is commonly used, but its accuracy can be influenced by patient positioning and device rotation.
Purpose of the Study:
- To determine the effect of fluoroscopic imaging position and rotation on the intraoperative assessment of condylar widening.
- To evaluate how knee flexion and varying degrees of fluoroscope rotation influence measurements of tibial plateau dimensions.
Main Methods:
- Prospective study of 33 patients with tibial plateau fractures.
- Fluoroscopic images of the uninjured tibial plateau were acquired in full extension and slight flexion.
- Images were taken at 5-degree increments of internal and external rotation up to 15 degrees.
Main Results:
- Lateral plateau width (LPW) was significantly decreased in flexion compared to extension across all rotation angles.
- A trend toward increased LPW was observed with internal rotation in flexion, reaching significance at 15 degrees.
- No significant differences were found in distal femoral condylar width (DFW), distal femoral articular width (FAW), or proximal tibial articular width (TAW) based on position or rotation.
Conclusions:
- Knee flexion leads to an underestimation of condylar width by approximately 2 mm compared to full extension.
- Fluoroscopic imaging rotation did not demonstrate a significant effect on condylar width measurements.
