Improved intra-operative reduction control using a three-dimensional mobile image intensifier — A proximal tibia cadaver study

Gösling, Thomas; Klingler, Karl; Geerling, J.; Shin, Hun-Kyu; Fehr, Michael; Krettek, Christian; Hüfner, T.

doi:10.1016/j.knee.2008.07.012

Cited by 23 publications

(14 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Computed tomography (CT) is nowadays indispensable in the understanding of fracture patterns precisely, especially in consideration of fracture line orientation, location, and magnitude of depression components [13, 14]. It provides surgeons with an opportunity to promote the ability of reduction and internal fixation.…”

Section: Introductionmentioning

confidence: 99%

The morphological features of different Schatzker types of tibial plateau fractures: a three-dimensional computed tomography study

et al. 2016

View full text Add to dashboard Cite

BackgroundTibial plateau fractures are of great challenge to treat with open reduction and internal fixation, because fractures vary from simple to complex, with little or extensive articular involvement. Hence, recognition and comprehension of the fracture features will help orthopedic surgeons understand the injury mechanism better and manage these fractures by planning optimal surgical procedures. This study aimed to evaluate the morphological characteristics of tibial plateau fractures based on the Schatzker classification.MethodsA total of 186 patients with 188 tibial plateau fractures from 2010 to 2014 in our hospital were reviewed using a computed tomography scan and three-dimensional (3D) reconstruction. The main fracture line angles (FLA) of Schatzker types I, II, and IV were measured. For each fracture, depression depth was measured, and the depression zone was also located. Depression zones were overlapped to obtain a frequency diagram.ResultsSchatzker type I and II fractures had three subtypes: single anterolateral fracture, single posterolateral fracture, and complex fracture (the anterolateral and posterolateral parts). Schatzker type IV fractures were also divided into three subtypes: single posteromedial fracture, single anteromedial fracture, and the whole medial fracture. For various Schatzker types and subtypes of fracture, fracture depression clustered and occurred at different locations of the tibial plateau. A significant difference was observed in the depression depth among the different Schatzker types (P < 0.01, Kruskal-Wallis test), especially between Schatzker type III and other types (Nemenyi test). There was no difference in the depression depth among the subtypes of Schatzker type II, whereas the difference was significant between the two subtypes of Schatzker type IV.ConclusionsSchatzker type I, II, and IV fractures could be divided into three corresponding subtypes by FLA. Various Schatzker types of fractures differed in location and depth of depression. A proper operative approach should be made based on the morphological characteristics of individual types of tibial plateau fractures.

show abstract

Section: Introductionmentioning

confidence: 99%

The morphological features of different Schatzker types of tibial plateau fractures: a three-dimensional computed tomography study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Earlier studies have shown that C-arm-based three-dimensional (3D) imaging devices are substantially better than standard fluoroscopy in terms of the evaluation of fracture reduction and implant position in tibial plateau fracture [1][2][3]. By use of intra-operative 3D imaging, malposition of implants or central depression fragments can be detected which was neglected on the 2D fluoroscopy [1][2][3]. In previous studies, the efficacy of 3D fluorosocpy in tibial plateau assessment has been assessed in cadavors [1], and general tibial fractures [3].…”

Section: Introductionmentioning

confidence: 99%

“…By use of intra-operative 3D imaging, malposition of implants or central depression fragments can be detected which was neglected on the 2D fluoroscopy [1][2][3]. In previous studies, the efficacy of 3D fluorosocpy in tibial plateau assessment has been assessed in cadavors [1], and general tibial fractures [3]. This modality is not completely tested clinically on complicated depressed tibial fractures with tremendous instrumentation.…”

Section: Introductionmentioning

confidence: 99%

“…The first generation of the 3D fluoroscopy (Iso-3D) was replaced by the second generation (Acardis orbit 3D), by the reason of more effective and of better imaging quality. The previous studies were focused on Iso-3D [1,3]. The current study was aimed to assess the imaging quality as well as clinical benefit of Acardis orbit 3D on complex depression tibial fractures with regarding to the raft screw technique.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative three-dimensional imaging in tibial plateau fractures with complex depressions

Ruan

Luo

Feng

et al. 2011

THC

View full text Add to dashboard Cite

Introduction: The aim of the study was to investigate the role of the intra-operative three-dimensional imaging in the tibial plateau fractures with complex depressions.Material and methods: Thirty tibial plateau fracture patients with complex depression were treated with the use of intraoperative three-dimensional imaging (Arcadis 3D). The image quality as well as the clinical benefit was evaluated.Results: In total 74 plates were used in these 30 patients. Six Kirschner wires and 50 screws were used outside the plate as raft technique in 4 and 21 patients. The additional critical imaging information which was unachievable in plain fluoroscopy was gain in 12 patients. Four patients among these 12 patients were revised because of the depression. Two patients were revised due to the misplacement of screws.Conclusion: The intra-operative three-dimensional imaging (Arcadis) is necessary when the two-dimensional fluoroscopy was unsatisfactory in the depressed tibial plateau fracture.

show abstract

“…This measurement lies within the clinical significance of anatomic reduction needed for cartilage healing [2]. A similar study using a simulated cadaveric tibial plateau model [17] did not find differences between CT scans and ISO-C3D in detecting minor step-offs in a cadaveric model. However, the authors of this study used a single screw for fixation and we believe that using multiple screws and a plate, as in our study, might have introduced more artifacts, simulating a more realistic clinical situation.…”

Section: Discussionmentioning

confidence: 59%

Assessment of two 3-D fluoroscopic systems for articular fracture reduction: a cadaver study

et al. 2011

View full text Add to dashboard Cite

show abstract

Improved intra-operative reduction control using a three-dimensional mobile image intensifier — A proximal tibia cadaver study

Cited by 23 publications

References 27 publications

The morphological features of different Schatzker types of tibial plateau fractures: a three-dimensional computed tomography study

The morphological features of different Schatzker types of tibial plateau fractures: a three-dimensional computed tomography study

Intraoperative three-dimensional imaging in tibial plateau fractures with complex depressions

Assessment of two 3-D fluoroscopic systems for articular fracture reduction: a cadaver study

Contact Info

Product

Resources

About