OBJECTIVE: The aim of the study was to assess the feasibility and benefit of the intraoperative use of a mobile C-arm with 3-dimensional imaging (ISO-C-3D). DESIGN: Prospective consecutive clinical study. SETTING: University hospital, level I trauma center. METHODS: The ISO-C-3D was used for intraoperative visualization in foot and ankle trauma care. Conventional C-arms were used to judge the reduction and implant position before the ISO-C-3D was used. Time spent, changes resulting from use of the ISO-C-3D, and surgeons' ratings (visual analogue scale, 0-10 points) were recorded. PATIENTS: Between January 1, 2003 and March 15, 2004, the ISO-C-3D was used in 62 cases (factures: pilon, n = 1; Weber-C ankles, n = 7; isolated dorsal Volkmann, n = 1; talus, n = 3; calcaneus, n = 20; navicular, n = 1; cuboid, n = 1; Lisfranc fracture-dislocation, n = 6; hindfoot arthrodesis with or without correction, n = 12). RESULTS: On average, the operation was interrupted for 440 seconds (range 330-700); 120 seconds, on average, for the ISO-C-3D scan and 210 seconds, on average, for evaluation of the images by the surgeon. In 39% of the cases (24 of 62), the reduction and/or implant position was corrected during the same procedure after the ISO-C-3D scan. The ratings of the 8 surgeons who used the ISO-C-3D were 9.2(5.2-10) for feasibility, 9.5 (6.1-10) for accuracy, and 8.2 (4.5-10) for clinical benefit. CONCLUSION: Intraoperative 3-dimensional visualization with the ISO-C-3D can provide useful information in foot and ankle trauma care that cannot be obtained from plain films or conventional C-arms. During the same procedure, after conventional C-arm scans judged the positioning to be correct and an ISO-C-3D scan was done, the reduction and/or implant position was corrected in 39% of the cases in this study, although not unnecessarily prolonging the operation. The ISO-C-3D appears to be most helpful in procedures with a closed reduction and internal fixation, and/or when axial reformations provide information that is not possible to obtain with a conventional C-arm and/or direct visualization during open reduction and internal fixation.
OBJECTIVE: The aim of the study was to assess the feasibility and benefit of the intraoperative use of a mobile C-arm with 3-dimensional imaging (ISO-C-3D). DESIGN: Prospective consecutive clinical study. SETTING: University hospital, level I trauma center. METHODS: The ISO-C-3D was used for intraoperative visualization in foot and ankle trauma care. Conventional C-arms were used to judge the reduction and implant position before the ISO-C-3D was used. Time spent, changes resulting from use of the ISO-C-3D, and surgeons' ratings (visual analogue scale, 0-10 points) were recorded. PATIENTS: Between January 1, 2003 and March 15, 2004, the ISO-C-3D was used in 62 cases (factures: pilon, n = 1; Weber-C ankles, n = 7; isolated dorsal Volkmann, n = 1; talus, n = 3; calcaneus, n = 20; navicular, n = 1; cuboid, n = 1; Lisfranc fracture-dislocation, n = 6; hindfoot arthrodesis with or without correction, n = 12). RESULTS: On average, the operation was interrupted for 440 seconds (range 330-700); 120 seconds, on average, for the ISO-C-3D scan and 210 seconds, on average, for evaluation of the images by the surgeon. In 39% of the cases (24 of 62), the reduction and/or implant position was corrected during the same procedure after the ISO-C-3D scan. The ratings of the 8 surgeons who used the ISO-C-3D were 9.2(5.2-10) for feasibility, 9.5 (6.1-10) for accuracy, and 8.2 (4.5-10) for clinical benefit. CONCLUSION: Intraoperative 3-dimensional visualization with the ISO-C-3D can provide useful information in foot and ankle trauma care that cannot be obtained from plain films or conventional C-arms. During the same procedure, after conventional C-arm scans judged the positioning to be correct and an ISO-C-3D scan was done, the reduction and/or implant position was corrected in 39% of the cases in this study, although not unnecessarily prolonging the operation. The ISO-C-3D appears to be most helpful in procedures with a closed reduction and internal fixation, and/or when axial reformations provide information that is not possible to obtain with a conventional C-arm and/or direct visualization during open reduction and internal fixation.
Authors: S Wirth; E Euler; D Kotsianos-Hermle; M Treitl; U Linsenmaier; K-J Pfeifer; M Reiser; W Mutschler Journal: Unfallchirurg Date: 2007-01 Impact factor: 1.000
Authors: Erin J Smith; Hisham A Al-Sanawi; Braden Gammon; Paul J St John; David R Pichora; Randy E Ellis Journal: Int J Comput Assist Radiol Surg Date: 2011-06-25 Impact factor: 2.924