Efficacy of 3-D-imaging in minimally-invasive screw fixation of proximal phalanx fractures: A cadaveric study

Abstract

The current study evaluated whether 3-D fluoroscopic imaging is capable of adequate visualisation, reduction and effective guidance of implant placement during a minimally-invasive screw-fixation (MISF) procedure in the treatment of proximal phalanx fractures. A comparison with conventional intraoperative 2-D imaging was performed in a cadaveric model. Conventional 2-D and 3-D imaging series were performed following the creation of proximal phalanx fractures, reduction and fixation, pre-and post-operatively. For both imaging modalities, attention was paid to A) correct reduction, B) screw-placement and, if present, C) intra-articular offset of fracture edges.The results revealed no related overall advantage of the 3-D imaging system over normal 2-D fluoroscopy at the proximal phalanx region. The authors conclude that, given the cost of 3-D imaging technology, as well as the increased time required for image acquisition, its routine use in the treatment of phalanx fracture cases is not justifiable at present.