Peroperatieve 3D-doorlichting bij intra-articulaire fracturen aan de extremiteiten*

During operative treatment of intra-articular fractures of the extremities, 2D fluoroscopy is often used for assessing the quality of fracture reduction and fixation and for making any necessary corrections.

Post-operative radiographs or CT scans, however, frequently reveal suboptimal reduction or fixation of the fracture.

To help prevent this, a 3D-fluoroscopy technique that can be used during surgery has been developed.

The radiation exposure from intra-operative 3D fluoroscopy is higher than that from 2D fluoroscopy, but significantly lower than exposure resulting from CT scanning. The diagnostic value of 3D fluoroscopy is comparable to that of CT scanning.

Extra corrections were performed during a considerably high percentage of operations (11-39%) using 3D fluoroscopy; it is unknown, however, whether corrections are required of all the defects detected.

In a randomised clinical trial, we are currently investigating the added value of 3D fluoroscopy in terms of the quality of procedures involving the reduction and fixation, as well as patient-relevant outcomes such as pain and joint function in the long term.

Conflict of interest: none declared. Financial support: M.S.H. Beerkamp is a research fellow employed at the AMC Research BV which received an unrestricted grant from Philips Healthcare, Best, the Netherlands.