[Intraoperative 3-dimensional imaging - beneficial or necessary?]. / Intraoperative dreidimensionale Bildgebung - nützlich oder notwendig?

ABSTRACT

BACKGROUND: With reference to two large retrospective studies we would like to make a contribution to the discussion whether intraoperative 3-dimensional imaging is only a helpful tool or state of the art for some special indications. METHODS: To answer this question the intraoperative revision rates of syndesmotic injuries and calcaneal fractures were analyzed over a period of 10 years and 8 years, respectively. Additionally, the clinical outcome was evaluated depending on the restoration of the joint reconstruction. RESULTS: Intraoperative revision rates of 32.7 % of 251 syndesmotic injuries and 40.3 % of 377 calcaneal fractures were found. The mutivariate analysis showed that residual joint incongruity leads to significantly worse clinical and radiological outcome of calcaneal fractures. CONCLUSIONS: Correct assessment of alignment and joint line reconstruction are not possible by means of fluoroscopy in every case of syndesmotic injuries and calcaneal fractures. Therefore, intraoperative 3-dimensional imaging should be used in the treatment of these injuries due to the high intraoperative revision rates and the clinical relevance.