title: [Multiplanar reconstruction with mobile 3D image intensifier. Surgical treatment of proximal humerus fractures].
abstract: OBJECTIVE
  The aim of this study was to analyze the applicability and advantages of the intraoperative use of a mobile 3D C-arm with multiplanar imaging for surgery of acute proximal humerus fractures.
  
  
  METHODS
  In this study 20 patients (11 female, 9 male, median age 70 years, range 35-91 years) with dislocated proximal humerus fractures (6 with 2 segments, 10 with 3 segments and 4 with 4 segments) were included. Preoperatively 3D scanning was performed and a reevaluation of the fracture in comparison to the plain radiographs was performed. After operative treatment another scan was performed to evaluate technical complications.
  
  
  RESULTS
  In comparison to the multiplanar reconstructions fracture morphology could not be correctly detected in 5 out of the 20 cases with plain radiographs. The preoperative image quality of the multiplanar reconstructions showed a significantly better assessment in comparison to the image quality with osteosynthesis (p < 0.05). The screws had to be replaced in 5 of the 20 patients.
  
  
  CONCLUSIONS
  Intraoperative 3D imaging with mobile image intensifier enables an accurate analysis of fracture morphology. Furthermore a quasi real time preoperative planning, evaluation of reduction and implant position with immediate operative relevance can be realized.
authors.affiliation: Klinik für Unfall- Wiederherstellungs- und Plastische Chirurgie, Universitätsklinikum Leipzig AöR, Liebigstraße 20, 04103, Leipzig, Deutschland, pierre.hepp@medizin.uni-leipzig.de.
authors.forename: P
authors.initials: P
authors.lastname: Hepp
authors.forename: J
authors.initials: J
authors.lastname: Theopold
authors.forename: J-S
authors.initials: JS
authors.lastname: Jarvers
authors.forename: B
authors.initials: B
authors.lastname: Marquaß
authors.forename: N
authors.initials: N
authors.lastname: von Dercks
authors.forename: C
authors.initials: C
authors.lastname: Josten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012784:Shoulder Fractures / Q000473:pathology* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014963:X-Ray Intensifying Screens