Detection of articular perforations of the proximal humerus fracture using a mobile 3D image intensifier – a cadaver study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-08-01

AUTHORS

Jan Theopold, Kevin Weihs, Christine Feja, Bastian Marquaß, Christoph Josten, Pierre Hepp

ABSTRACT

BackgroundThe purpose of this study was to investigate the accuracy of perforation detection with multiplanar reconstructions using a mobile 3D image intensifier.MethodsIn 12 paired human humeri, K-wires perforating the subchondral bone and placed just below the cartilage level were directed toward five specific regions in the humeral head. Image acquisition was initiated by a fluoroscopy scan. Within a range of 90°, 45° external rotation (ER) and 45° internal rotation (IR). The number and percentage of detected perforating screws were grouped and analyzed. Furthermore, the fluoroscopic images were converted into multiplanar CT-like reconstructions. Each K-wire perforation was characterized as “detected” or “not detected”.ResultsIn the series of fluoroscopy images in the standard neutral position at 30° internal rotation, and 30° external rotation, the perforations of all K-wires (n = 56) were detected. Twenty-nine (51.8%) of them were detected in one AP view, 22 (39.3%) in two AP views, and five (8.9%) in three AP views. All K-wire perforations (100%, n = 56) were detected in multiplanar reconstructions.ConclusionIn order to reveal all of the intraoperative and postoperative screw perforations in a “five screw configuration”, conventional AP images should be established in both the neutral positions (0°), at 30° internal rotation and 30° external rotation. Alternatively, the intraoperative 3D scan with multiplanar reconstructions enables a 100% rate of detection of the screw perforations. More... »

PAGES

47

References to SciGraph publications

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  • 2015-07-22. Clinical outcomes of allograft with locking compression plates for elderly four-part proximal humerus fractures in JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
  • 2011-04-09. Proximal Humerus Fractures in the Elderly Can Be Reliably Fixed With a “Hybrid” Locked-plating Technique in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2013-05-25. Multiplanare Rekonstruktion mit mobilem 3D-Bildwandler in DER UNFALLCHIRURG
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  • 2011-09-18. Evaluation of 2D and 3D navigation for iliosacral screw fixation in INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY
  • 2009-05-14. Bone quality measured by the radiogrammetric parameter “cortical index” and reoperations after locking plate osteosynthesis in patients sustaining proximal humerus fractures in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2011-04-01. 3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws in EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
  • 2015-01-01. Lessons learned from treating patients with unstable multifragmentary fractures of the proximal humerus by minimal invasive plate osteosynthesis in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2008-09-13. Does intraoperative fluoroscopic 3D imaging provide extra information for fracture surgery? in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2006-12. Die winkelstabile Osteosynthese am proximalen Humerus mit der PHILOS-Platte in DER UNFALLCHIRURG
  • 2014-03-30. Behandlung proximaler Humerusfrakturen in Deutschland in DER UNFALLCHIRURG
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12880-017-0201-0

    DOI

    http://dx.doi.org/10.1186/s12880-017-0201-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1090935554

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28764643


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    61 images
    62 intensifier
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    65 levels
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    67 neutral position
    68 number
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    70 percentage
    71 perforation
    72 perforation detection
    73 position
    74 proximal humerus fractures
    75 purpose
    76 range
    77 rate
    78 rate of detection
    79 reconstruction
    80 region
    81 rotation
    82 scans
    83 screw configuration
    84 screw perforation
    85 screws
    86 series
    87 specific regions
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