Trauma surgery of the extremities: the difference between what the surgeon thinks and intraoperative 3D-RX shows

摘要

Introduction: With the use of conventional C-arm fluoroscopy in trauma surgery of the extremities, wrong positioning of implants (i.e. screws, plates) and joint incongruencies frequently remain unrevealed. These imperfections are only recognized on post-operative Computed Tomography (CT) scans. With the BV Pulsera 3D-RX (Philips Medical Systems, Best, NL) intra-operative 3D images can be obtained during surgery. The Pulsera 3D is a normal C-arm with 3D rotational X-ray (3D-RX) functionalities and thus able to provide normal (2D) fluoroscopy images as well as 3D reconstruction. This type of imaging gives extra information and allows the surgeon to recognize problems with fracture reduction and/or fixation during the operation. At the same time, adequate reduction and fixation can be confirmed. With the intraoperative 3D-RX imaging, detailed information is obtained during or at the end of the procedure, allowing corrections if necessary.