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Archives of Orthopaedic and Trauma Surgery

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10.01.2018 | Trauma Surgery

Intraoperative three-dimensional imaging in the treatment of distal radius fractures

verfasst von: Marc Schnetzke, Julia Fuchs, Sven Y. Vetter, Benedict Swartman, Holger Keil, Paul-Alfred Grützner, Jochen Franke

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 4/2018

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Abstract

Introduction

In operative treatment of distal radius fractures satisfying outcome mainly relies on anatomical fracture reduction and correct implant placement. Examination with two-dimensional fluoroscopy may not provide reliable information about this. The aim of this study was to determine the effectiveness of additional intraoperative three-dimensional imaging in the operative treatment of comminuted distal radius fractures.

Materials and methods

From August 2001 to June 2015, patients with a distal radius fracture who were treated operatively and received intraoperative three-dimensional scan were included. The findings of the three-dimensional scan were documented by the operative surgeon and analyzed retrospectively with regard to incidence and the need for intraoperative revisions. Clinical evaluation included the patient’s medical history, the injury pattern of the affected wrist (according to the OTA/AO fracture classification) and concomitant injuries. Intraoperative and postoperative complications and revision surgeries were evaluated as well.

Results

Of 4515 operatively treated distal radius fractures, 307 (6.8%) received additional intraoperative three-dimensional imaging during surgery. 263 of 307 patients (85.7%) had a distal radius fracture type C. Intraoperative three-dimensional imaging revealed findings in 125 patients (40.7%) that were not detected on conventional two-dimensional fluoroscopy. In 54 patients (17.6%) these findings led to an immediate revision. Most commonly, revision was done in the case of remaining steps in the articular surface ≥ 1 mm (n = 25, 8.1%) followed by intra-articular screw placement (n = 23, 7.5%).

Conclusions

Intraoperative three-dimensional imaging can provide additional information compared to conventional two-dimensional fluoroscopy in the operative treatment of distal radius fractures with the possibility of immediate intraoperative revision.

Arora R, Lutz M, Deml C, Krappinger D, Haug L, Gabl M (2011) A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint Surg Am 93(23):2146–2153. https://doi.org/10.2106/jbjs.j.01597 CrossRefPubMed

Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M (2007) Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 21(5):316–322. https://doi.org/10.1097/BOT.0b013e318059b993 CrossRefPubMed

Atesok K, Finkelstein J, Khoury A, Peyser A, Weil Y, Liebergall M, Mosheiff R (2007) The use of intraoperative three-dimensional imaging (ISO-C-3D) in fixation of intraarticular fractures. Injury 38(10):1163–1169. https://doi.org/10.1016/j.injury.2007.06.014 CrossRefPubMed

Beerekamp MS, Sulkers GS, Ubbink DT, Maas M, Schep NW, Goslings JC (2012) Accuracy and consequences of 3D-fluoroscopy in upper and lower extremity fracture treatment: a systematic review. Eur J Radiol 81(12):4019–4028. https://doi.org/10.1016/j.ejrad.2012.06.021 CrossRefPubMed

Bentohami A, de Burlet K, de Korte N, van den Bekerom MP, Goslings JC, Schep NW (2014) Complications following volar locking plate fixation for distal radial fractures: a systematic review. J Hand Surg Eur Vol 39(7):745–754. https://doi.org/10.1177/1753193413511936 CrossRefPubMed

Brunner A, Siebert C, Stieger C, Kastius A, Link BC, Babst R (2015) The dorsal tangential X-ray view to determine dorsal screw penetration during volar plating of distal radius fractures. J Hand Surg Am 40(1):27–33. https://doi.org/10.1016/j.jhsa.2014.10.021 CrossRefPubMed

Carelsen B, van Loon J, Streekstra GJ, Maas M, van Kemenade P, Strackee SD (2011) First experiences with the use of intraoperative 3D-RX for wrist surgery. Minim Invasive Therapy Allied Technol 20(3):160–166. https://doi.org/10.3109/13645706.2010.518807 CrossRef

Catalano LW 3rd, Barron OA, Glickel SZ (2004) Assessment of articular displacement of distal radius fractures. Clin Orthop Relat Res 423:79–84CrossRef

Cooney WP 3rd, Linscheid RL, Dobyns JH (1979) External pin fixation for unstable Colles’ fractures. J Bone Joint Surg Am 61(6a):840–845CrossRefPubMed

10.

Dario P, Matteo G, Carolina C, Marco G, Cristina D, Daniele F, Andrea F (2014) Is it really necessary to restore radial anatomic parameters after distal radius fractures? Injury 45(Suppl 6):S21–S26. https://doi.org/10.1016/j.injury.2014.10.018 PubMed

11.

Edwards CC, 2nd, Haraszti CJ, McGillivary GR, Gutow AP (2001) Intra-articular distal radius fractures: arthroscopic assessment of radiographically assisted reduction. J Hand Surg Am 26(6):1036–1041. https://doi.org/10.1053/jhsu.2001.28760 CrossRefPubMed

12.

Franke J, Wendl K, Suda AJ, Giese T, Grutzner PA, von Recum J (2014) Intraoperative three-dimensional imaging in the treatment of calcaneal fractures. J Bone Joint Surg Am 96(9):e72. https://doi.org/10.2106/jbjs.l.01220 CrossRefPubMed

13.

Ganesh D, Service B, Zirgibel B, Koval K (2016) The detection of prominent hardware in volar locked plating of distal radius fractures: intraoperative fluoroscopy versus computed tomography. J Orthop Trauma 30(11):618–621. https://doi.org/10.1097/bot.0000000000000661 CrossRefPubMed

14.

Hill BW, Shakir I, Cannada LK (2015) Dorsal screw penetration with the use of volar plating of distal radius fractures: how can you best detect? J Orthop Trauma 29(10):e408–e413. https://doi.org/10.1097/bot.0000000000000361 CrossRefPubMed

15.

Hufner T, Stubig T, Gosling T, Kendoff D, Geerling J, Krettek C (2007) Cost-benefit analysis of intraoperative 3D imaging. Unfallchirurg 110(1):14–21. https://doi.org/10.1007/s00113-006-1202-6 CrossRefPubMed

16.

Karl JW, Olson PR, Rosenwasser MP (2015) The epidemiology of upper extremity fractures in the united states, 2009. J Orthop Trauma 29(8):e242–e244. https://doi.org/10.1097/bot.0000000000000312 CrossRefPubMed

17.

Kendoff D, Citak M, Gardner MJ, Stubig T, Krettek C, Hufner T (2009) Intraoperative 3D imaging: value and consequences in 248 cases. J Trauma 66(1):232–238. https://doi.org/10.1097/TA.0b013e31815ede5d CrossRefPubMed

18.

Lee SK, Bae KW, Choy WS (2013) Use of the radial groove view intra-operatively to prevent damage to the extensor pollicis longus tendon by protruding screws during volar plating of a distal radial fracture. Bone Joint J 95(b 10):1372–1376. https://doi.org/10.1302/0301-620x.95b10.31453 CrossRefPubMed

19.

Leung KS, Shen WY, Tsang HK, Chiu KH, Leung PC, Hung LK (1990) An effective treatment of comminuted fractures of the distal radius. J Hand Surg Am 15(1):11–17CrossRefPubMed

20.

Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B, Audige L (2007) Fracture and dislocation classification compendium-2007: orthopaedic trauma association classification, database and outcomes committee. J Orthop Trauma 21(10 suppl):S1–S133CrossRefPubMed

21.

Matschke S, Marent-Huber M, Audige L, Wentzensen A (2011) The surgical treatment of unstable distal radius fractures by angle stable implants: a multicenter prospective study. J Orthop Trauma 25(5):312–317. https://doi.org/10.1097/BOT.0b013e3181f2b09e CrossRefPubMed

22.

Matschke S, Wentzensen A, Ring D, Marent-Huber M, Audige L, Jupiter JB (2011) Comparison of angle stable plate fixation approaches for distal radius fractures. Injury 42(4):385–392. https://doi.org/10.1016/j.injury.2010.10.010 CrossRefPubMed

23.

Mehling I, Rittstieg P, Mehling AP, Kuchle R, Muller LP, Rommens PM (2013) Intraoperative C-arm CT imaging in angular stable plate osteosynthesis of distal radius fractures. J Hand Surg Eur 38(7):751–757. https://doi.org/10.1177/1753193413476418 CrossRef

24.

Meier R, Geerling J, Hufner T, Kfuri M, Krettek C (2011) The isocentric C-arm. Visualization of fracture reduction and screw position in the radius. Unfallchirurg 114(7):587–590. https://doi.org/10.1007/s00113-011-2008-8 CrossRefPubMed

25.

Meier R, Kfuri M Jr, Geerling J, Hufner T, Krimmer H, Krettek C (2005) Intraoperative three-dimensional imaging with an isocentric mobile C-arm at the wrist. Handchir Mikrochir Plast Chir 37(4):256–259. https://doi.org/10.1055/s-2004-830563 CrossRefPubMed

26.

Ono H, Furuta K, Fujitani R, Katayama T, Akahane M (2010) Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach. J Orthop Sci 15(4):502–508. https://doi.org/10.1007/s00776-010-1484-y CrossRefPubMed

27.

Orbay JL, Fernandez DL (2004) Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg Am 29(1):96–102CrossRefPubMed

28.

Rausch S, Marintschev I, Graul I, Wilharm A, Klos K, Hofmann GO, Florian Gras M (2015) Tangential view and intraoperative three-dimensional fluoroscopy for the detection of screw-misplacements in volar plating of distal radius fractures. Arch Trauma Res 4(2):e24622. https://doi.org/10.5812/atr.4(2)2015.24622 CrossRefPubMedPubMedCentral

29.

Richter M, Zech S (2009) Intraoperative 3-dimensional imaging in foot and ankle trauma-experience with a second-generation device (ARCADIS-3D). J Orthop Trauma 23(3):213–220. https://doi.org/10.1097/BOT.0b013e31819867f6 CrossRefPubMed

30.

Ruch DS, Vallee J, Poehling GG, Smith BP, Kuzma GR (2004) Arthroscopic reduction versus fluoroscopic reduction in the management of intra-articular distal radius fractures. Arthroscopy 20(3):225–230. https://doi.org/10.1016/j.arthro.2004.01.010 CrossRefPubMed

31.

Souer JS, Ring D, Jupiter JB, Matschke S, Audige L, Marent-Huber M (2009) Comparison of AO type-B and type-C volar shearing fractures of the distal part of the radius. J Bone Joint Surg Am 91(11):2605–2611. https://doi.org/10.2106/jbjs.h.01479 CrossRefPubMed

32.

Takemoto RC, Gage M, Rybak L, Zimmerman I, Egol KA (2012) Accuracy of detecting screw penetration of the radiocarpal joint following volar plating using plain radiographs versus computed tomography. Am J Orthop (Belle Mead NJ) 41(8):358–361

33.

Tweet ML, Calfee RP, Stern PJ (2010) Rotational fluoroscopy assists in detection of intra-articular screw penetration during volar plating of the distal radius. J Hand Surg Am 35(4):619–627. https://doi.org/10.1016/j.jhsa.2009.12.033 CrossRefPubMedPubMedCentral

34.

Vanhaecke J, Fernandez DL (2015) DVR plating of distal radius fractures. Injury. https://doi.org/10.1016/j.injury.2015.08.010 PubMed

35.

Ward CM, Kuhl TL, Adams BD (2011) Early complications of volar plating of distal radius fractures and their relationship to surgeon experience. Hand (N Y) 6(2):185–189. https://doi.org/10.1007/s11552-010-9313-5 CrossRef

36.

Weil YA, Liebergall M, Mosheiff R, Singer SB, Joskowicz L, Khoury A (2011) Assessment of two 3-D fluoroscopic systems for articular fracture reduction: a cadaver study. Int J Comput Assist Radiol Surg 6(5):685–692. https://doi.org/10.1007/s11548-011-0548-6 CrossRefPubMed

Titel: Intraoperative three-dimensional imaging in the treatment of distal radius fractures
verfasst von: Marc Schnetzke
Julia Fuchs
Sven Y. Vetter
Benedict Swartman
Holger Keil
Paul-Alfred Grützner
Jochen Franke
Publikationsdatum: 10.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 4/2018
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2867-3

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Intraoperative three-dimensional imaging in the treatment of distal radius fractures

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Introduction

Materials and methods

Results

Conclusions

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