[术中三维成像——有益还是必要？]
[Intraoperative 3-dimensional imaging - beneficial or necessary?].
作者信息
Franke J, von Recum J, Wendl K, Grützner P A
机构信息
MINTOS - Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Unfallchirurgische Klinik an der Ruprecht-Karls-Universität Heidelberg, AGiTEC - Arbeitsgemeinschaft für intraoperative Bildgebung und Technologie Integration der DGOU, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Deutschland.
出版信息
Unfallchirurg. 2013 Feb;116(2):185-90. doi: 10.1007/s00113-013-2359-4.
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.
背景
参考两项大型回顾性研究，我们希望为关于术中三维成像仅是一种有用工具还是某些特殊适应症的先进技术的讨论做出贡献。
方法
为回答这个问题，分别分析了10年期间的下胫腓联合损伤和8年期间的跟骨骨折的术中翻修率。此外，根据关节重建的恢复情况评估临床结果。
结果
发现251例下胫腓联合损伤的术中翻修率为32.7%，377例跟骨骨折的术中翻修率为40.3%。多变量分析表明，残留关节不匹配会导致跟骨骨折的临床和放射学结果明显更差。
结论
在每例下胫腓联合损伤和跟骨骨折中，通过透视不可能正确评估对线和关节面重建。因此，由于术中翻修率高和临床相关性，术中三维成像应应用于这些损伤的治疗。
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