Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems

Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems

Abstract Objectives To compare intraoperative 3D fluoroscopy with a ceiling-mounted flat panel detector in plate osteosynthesis of distal radius fractures (AO/OTA 2R3C1.2) with volar locking plate systems to conventional 2D fluoroscopy for detection of insufficient fracture reduction, plate misplace...

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Autores principales: Raphael Seuthe, Andreas Seekamp, Bodo Kurz, Julian Pfarr, Jost Philipp Schaefer, Simon Peh, Sebastian Lippross
Formato: article
Lenguaje:EN
Publicado: BMC 2021
Materias:
Distal radius fracture
Insufficient fracture reduction
Plate misplacement
Screw misplacement
Intraarticular screw
Protruding screw
Diseases of the musculoskeletal system
RC925-935
Acceso en línea:https://doaj.org/article/c3755d2bb7674e308c36664887a69fc8
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spelling oai:doaj.org-article:c3755d2bb7674e308c36664887a69fc82021-11-08T10:58:23ZComparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems10.1186/s12891-021-04784-71471-2474https://doaj.org/article/c3755d2bb7674e308c36664887a69fc82021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04784-7https://doaj.org/toc/1471-2474Abstract Objectives To compare intraoperative 3D fluoroscopy with a ceiling-mounted flat panel detector in plate osteosynthesis of distal radius fractures (AO/OTA 2R3C1.2) with volar locking plate systems to conventional 2D fluoroscopy for detection of insufficient fracture reduction, plate misplacement and protruding screws. Methods Using a common volar approach on 12 cadaver forearms, total intraarticular distal radius fractures were induced, manually reduced and internally fixated with a 2.4 distal radius locking compression plate. 2D (anterior-posterior and lateral) and 3D (rotational) fluoroscopic images were taken as well as computed tomographies. Fluoroscopic images, Cone Beam CT (CBCT), 360° rotating sequences (so called “Movies”) and CT scans were co-evaluated by a specialist orthopedic surgeon and a specialist radiologist regarding quality of fracture reduction, position of plate, position of the three distal locking screws and position of the three diaphyseal screws. In reference to gold standard CT, sensitivity and specifity were analyzed. Results “Movie” showed highest sensitivity for detection of insufficient fracture reduction (88%). Sensitivity for detection of incorrect position of plate was 100% for CBCT and 90% for “Movie.” For intraarticular position of screws, 2D fluoroscopy and CBCT showed highest sensitivity and specifity (100 and 91%, respectively). Regarding detection of only marginal intraarticular position of screws, sensitivity and specifity of 2D fluoroscopy reached 100% (CBCT: 100 and 83%). “Movie” showed highest sensitivity for detection of overlapping position of screws (100%). When it comes to specifity, CBCT achieved 100%. Regarding detection of only marginal overlapping position of screws, 2D fluoroscopy and “Movie” showed highest sensitivity (100%). CBCT achieved highest specifity (100%). Conclusion As for assessment of quality of fracture reduction and detection of incorrect position of plate as well as overlapping position of the three diaphyseal screws CBCT and “Movie” are comparable to CT – especially when combined. Particularly sensitivity is high compared to standard 2D fluoroscopy.Raphael SeutheAndreas SeekampBodo KurzJulian PfarrJost Philipp SchaeferSimon PehSebastian LipprossBMCarticleDistal radius fractureInsufficient fracture reductionPlate misplacementScrew misplacementIntraarticular screwProtruding screwDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-9 (2021)
institution DOAJ
collection DOAJ
language EN
topic Distal radius fracture
Insufficient fracture reduction
Plate misplacement
Screw misplacement
Intraarticular screw
Protruding screw
Diseases of the musculoskeletal system
RC925-935
spellingShingle Distal radius fracture
Insufficient fracture reduction
Plate misplacement
Screw misplacement
Intraarticular screw
Protruding screw
Diseases of the musculoskeletal system
RC925-935
Raphael Seuthe
Andreas Seekamp
Bodo Kurz
Julian Pfarr
Jost Philipp Schaefer
Simon Peh
Sebastian Lippross
Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems
description Abstract Objectives To compare intraoperative 3D fluoroscopy with a ceiling-mounted flat panel detector in plate osteosynthesis of distal radius fractures (AO/OTA 2R3C1.2) with volar locking plate systems to conventional 2D fluoroscopy for detection of insufficient fracture reduction, plate misplacement and protruding screws. Methods Using a common volar approach on 12 cadaver forearms, total intraarticular distal radius fractures were induced, manually reduced and internally fixated with a 2.4 distal radius locking compression plate. 2D (anterior-posterior and lateral) and 3D (rotational) fluoroscopic images were taken as well as computed tomographies. Fluoroscopic images, Cone Beam CT (CBCT), 360° rotating sequences (so called “Movies”) and CT scans were co-evaluated by a specialist orthopedic surgeon and a specialist radiologist regarding quality of fracture reduction, position of plate, position of the three distal locking screws and position of the three diaphyseal screws. In reference to gold standard CT, sensitivity and specifity were analyzed. Results “Movie” showed highest sensitivity for detection of insufficient fracture reduction (88%). Sensitivity for detection of incorrect position of plate was 100% for CBCT and 90% for “Movie.” For intraarticular position of screws, 2D fluoroscopy and CBCT showed highest sensitivity and specifity (100 and 91%, respectively). Regarding detection of only marginal intraarticular position of screws, sensitivity and specifity of 2D fluoroscopy reached 100% (CBCT: 100 and 83%). “Movie” showed highest sensitivity for detection of overlapping position of screws (100%). When it comes to specifity, CBCT achieved 100%. Regarding detection of only marginal overlapping position of screws, 2D fluoroscopy and “Movie” showed highest sensitivity (100%). CBCT achieved highest specifity (100%). Conclusion As for assessment of quality of fracture reduction and detection of incorrect position of plate as well as overlapping position of the three diaphyseal screws CBCT and “Movie” are comparable to CT – especially when combined. Particularly sensitivity is high compared to standard 2D fluoroscopy.
format article
author Raphael Seuthe
Andreas Seekamp
Bodo Kurz
Julian Pfarr
Jost Philipp Schaefer
Simon Peh
Sebastian Lippross
author_facet Raphael Seuthe
Andreas Seekamp
Bodo Kurz
Julian Pfarr
Jost Philipp Schaefer
Simon Peh
Sebastian Lippross
author_sort Raphael Seuthe
title Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems
title_short Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems
title_full Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems
title_fullStr Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems
title_full_unstemmed Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems
title_sort comparison of a ceiling-mounted 3d flat panel detector vs. conventional intraoperative 2d fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems
publisher BMC
publishDate 2021
url https://doaj.org/article/c3755d2bb7674e308c36664887a69fc8
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