Intraoperative fluoroscopy to evaluate fracture reduction and hardware placement during acetabular surgery.

OBJECTIVES

To evaluate use of intraoperative fluoroscopy during acetabular surgery to determine fracture reduction and accurate placement of screws.

DESIGN

Retrospective.

SETTING

Level I trauma center.

PARTICIPANTS

Thirty patients with thirty-two acetabular fractures.

INTERVENTION

Patients were evaluated with fluoroscopy during surgery to assess fracture reduction and screw placement. Anterior-posterior (AP), oblique, and lateral pelvic fluoroscopic images were obtained intraoperatively. Postoperative radiographs were used to verify fluoroscopic findings; computed tomography (CT) scans were used as the control to assess intraarticular screw placement.

MAIN OUTCOME MEASUREMENTS

Radiographic and clinical assessment of fracture reduction and screw placement.

RESULTS

Intraoperative fluoroscopy confirmed the extra-articular position of all screws evaluated. Postoperative CT scans confirmed the extra-articular placement of all screws assessed by fluoroscopy. Quality of reduction using intraoperative fluoroscopic images had a 100 percent correlation with reduction on final radiographs. One patient, with two screws placed without fluoroscopic evaluation, had intra-articular placement requiring revision surgery.

CONCLUSIONS

Intraoperative fluoroscopy is effective in evaluating both acetabular fracture reduction and hardware placement.