INTRAOPERATIVE COMPUTED TOMOGRAPHY: AN ADVANCED APPROACH FOR VISUALIZATION OF FIXATION MATERIAL IN DISTAL RADIUS...

Area of Science:

• Orthopedic Surgery
• Radiology
• Medical Imaging

Background:

• Distal radius fractures are common injuries requiring surgical fixation.
• Accurate placement of intra-articular screws is crucial for successful osteosynthesis.
• Current imaging techniques may have limitations in detecting screw malposition.

Purpose of the Study:

• To compare the diagnostic efficacy of 2D fluoroscopy and intraoperative computed tomography (CT) in identifying intra-articular screws.
• To assess the ability of each imaging modality to detect screws that extend beyond the dorsal cortex in distal radius fractures.

Main Methods:

• A prospective study was conducted involving 10 patients undergoing osteosynthesis for distal radius fractures.
• The accuracy of 2D fluoroscopy and intraoperative CT in screw placement assessment was evaluated.
• Detection rates for intra-articular screws and dorsal cortex breaches were recorded.

Main Results:

• 2D fluoroscopy failed to identify any instances of inadequate screw positioning.
• Intraoperative CT detected 20% of intra-articular screws and 60% of screws that breached the dorsal cortex.
• A significant difference in detection rates was observed between the two modalities.

Conclusions:

• Intraoperative CT demonstrates superior effectiveness in detecting malpositioned intra-articular screws compared to 2D fluoroscopy.
• Utilizing intraoperative CT can enhance surgical accuracy and potentially reduce postoperative complications associated with screw malplacement.
• This finding supports the use of intraoperative CT for improved screw positioning verification in distal radius fracture fixation.