OTA 2006 Posters

Scientific Poster #42 Foot and Ankle

Intraoperative Three-Dimensional Imaging (ISO-C-3D) in
Trauma Surgery
Kivanc Atesok, MD (*); Amal Khoury, MD (*); Amos Peyser, MD (*);
Yoram Weil, MD (*); Meir Liebergall, MD (*); Rami Mosheiff, MD (*);
Department of Orthopaedics, Hadassah University Hospital, Jerusalem, Israel

Background: The purpose of this study is to evaluate the applicability and advantages of the intraoperative use of a mobile isocentric C-arm with 3-dimensional imaging (SIREMOBIL ISO-C-3D) in trauma surgery.

Methods: Between November 2004 and January 2006, the ISO-C-3D was used at our institution for intraoperative CT-quality visualization of 52 trauma cases with fractures of calcaneus (19), tibial plateau (12), tibial plafond (8), acetabulum (8), distal radius (3), talus (1) and ankle (1). The mean patient age was 42 and male to female ratio 38 to 14. In 47 cases ISO-C-3D was used during the surgery after the reduction and fixation of the fracture to assess the accuracy of reduction and implant position prior to wound closure, and in 5 cases the device was used before starting the operation to obtain real-time CT images that were transferred to a navigation system to perform computer-navigated procedures.

Results: This novel technique was highly beneficial from four aspects: intraoperative diagnosis, proper reduction, correct implant placement, and feasibility in combining the CT images to computer navigation. In 33% of all the patients (17/52), who had no regular CT scan before the surgery, intraoperative 3-dimensional imaging with ISO-C-3D has been a superior modality in diagnosis. Excluding the patients who were operated by CT image-based navigation, in 11% of the cases (5/47), the reduction and implant position was corrected during the surgery after the ISO-C-3D scan. In all the procedures with ISO-C-3D navigation, satisfactory reconstruction of the articular surfaces with precise fixation was achieved.

Conclusion: Intraoperative 3-dimensional visualization with ISO-C-3D provides useful information in trauma surgery that enables the surgeon to re-evaluate the injury diagnostically and to judge the reduction and implant position before wound closure. Combining the ISO-C-3D images with computer navigation makes the reduction and implant placement highly accurate.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.
· The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an "off label" use). · · FDA information not available at time of printing.