Intraoperative 3-dimensional imaging of scaphoid fracture reduction and fixation

Abstract

IntroductionWe examined the clinical benefit of two intraoperative three-dimensional imaging modalities for reduction and fixation of scaphoid fractures. HypothesisOur hypothesis was that three dimensional imaging will aid in operative care in comparison with standard fluoroscopy. MethodsIn 25 consecutive patients treated for fractures, after satisfactory reduction and fixation was obtained with a single Kirschner wire using fluoroscopy, intraoperative three-dimensional visualization was performed. The quality of fracture reduction, wire position and extrusion of the wire were examined. ResultsIn two of the 25 cases, after three-dimensional visualization, malreduction of the fracture was seen and the reduction revised. Artifact and the dependency on technologist performance, limited the use of these modalities to locate the wire accurately. DiscussionDiagnosis of malreduction of a scaphoid fracture is possible with 3-dimensional modalities. Utilization of these systems is still limited by technical factors. Level of evidenceLevel IV. Retrospective study.