[Comparison of C-arm CT and standard imaging in osteosyntheses of fractured distal radius specimens].
BACKGROUND
The purpose of this study was to evaluate the value of C-arm CT imaging of the distal radius with standard patient positioning in intraoperative assessment of plate osteosynthesis.


METHODS
Four complete distal radius specimens from human cadavers were fractured (type C), and internal fixation with palmar plates (stainless steel) was then carried out in each. On the basis of C-arm fluoroscopy, radiography and C-arm CT (Siremobil Iso-C3D, scans with forearm bones positioned parallel to the z-axis), 19 observers subsequently evaluated the positions of screws near the joint and any steps within the joint, after which the bones were surgically exposed and the imaging results checked against direct visual observations.


RESULTS
No statistically significant differences were detected either between the modalities or between the evaluator groups.


CONCLUSIONS
With standard patient positioning, the performance of C-arm CT was equivalent to and not better than that of current standard procedures, i.e. intraoperative fluoroscopy and postoperative radiography. Further studies should examine whether this holds true in clinical practice with representative patient collectives when titanium implants are used and/or optimized patient positioning is practised.
Wirth
S
S
Institut für Klinische Radiologie, Klinikum der Universität München, München. Stefan.Wirth@med.uni-muenchen.de
Euler
E
E
Kotsianos-Hermle
D
D
Treitl
M
M
Linsenmaier
U
U
Pfeifer
K-J
KJ
Reiser
M
M
Mutschler
W
W
D002102:Cadaver; D005593:Fracture Fixation, Internal; D006801:Humans; D011856:Radiographic Image Enhancement / Q000379:methods*; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery