C-arm fluoroscopy in orthopaedic surgical practice

Ojodu, Ishaq; Ogunsemoyin, A; Hopp, Sascha; Pohlemann, Tim; Oluwole, Ige; Akinola, Oluwaseun

doi:10.1007/s00590-018-2234-7

Cited by 31 publications

(18 citation statements)

References 41 publications

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“…Using the BioComposite interference screws as a support and fixation of the reduced fragment allows one to avoid the titanium or steel implants usually used for depressed tibial plateau fracture fixation. [1][2][3]11 This technique also eliminates the necessity for a second operation performed for implant removal and eliminates the risk of skin irritation over the implants. A similar technique was described by Lubowitz et al 12 In our technique, we use more BioComposite interference screws, potentially creating more stable support beneath the fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Fluoroscopy is required to create a tunnel beneath the articular surface and to perform BioComposite interference screw placement, which puts the patient and operating staff at risk of radiation exposure. 11 Drilling a guidewire through the articular surface creates a risk of iatrogenic cartilage lesions on the femoral side or displacement of the fracture fragment into the joint. Furthermore, this technique requires drilling of the tunnel in the proximal tibia; thus, an ACL aiming guide is necessary.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopy-Assisted Management of Schatzker Type III Lateral Tibial Plateau Fracture With Interference Screw Fixation

Hermanowicz¹,

Mrozek²,

Góralczyk³

et al. 2021

Arthroscopy Techniques

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Tibial plateau fractures occur in both old and young patients and may be caused by low-energy trauma, as well as high-energy trauma. Owing to the variety of injury mechanisms and fracture patterns, tibial plateau fractures are very challenging to treat. One of the most demanding fractures is the type III fracture according to the Schatzker classification, which is a pure depression of the lateral tibial plateau. Treatment with open surgical procedures is associated with vast soft-tissue trauma and prolonged recovery after surgery. Although soft-tissue trauma is minimized and visual control is improved throughout arthroscopy-assisted surgical procedures, internal fixation using buttress plates or lag screws is still required to reduce and fix the depressed plateau. We present an arthroscopy-assisted technique of reduction and fixation of the lateral tibial plateau fracture with 3 BioComposite interference screws (Arthrex, Munich, Germany) that provides a high amount of stability and reduces patient immobilization, allowing for faster rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Arthroscopy-Assisted Management of Schatzker Type III Lateral Tibial Plateau Fracture With Interference Screw Fixation

Hermanowicz¹,

Mrozek²,

Góralczyk³

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

show abstract

“…In addition to the planning and guidance delivered with preoperative scans, intraoperative imaging plays an important role in intraoperative lesion localization, decision making, and subsequent confirmation. Intraoperative imaging was first introduced in the context of X-rays at the beginning of the twentieth century and has since then evolved to provide a direct anatomical context within the operating room using, for example, a C-arm during orthopedic surgery [89]. Other forms of intraoperative anatomical imaging included the often used intraoperative US (e.g., to evaluate the extent of a tumor lesion during liver surgery [90]), or even intraoperative MRI (e.g., surgical management of glioblastoma [91]).…”

Section: Intraoperative Planning Decision and Excision Assistancementioning

confidence: 99%

How molecular imaging will enable robotic precision surgery

Wendler

Leeuwen

Navab

et al. 2021

Eur J Nucl Med Mol Imaging

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Molecular imaging is one of the pillars of precision surgery. Its applications range from early diagnostics to therapy planning, execution, and the accurate assessment of outcomes. In particular, molecular imaging solutions are in high demand in minimally invasive surgical strategies, such as the substantially increasing field of robotic surgery. This review aims at connecting the molecular imaging and nuclear medicine community to the rapidly expanding armory of surgical medical devices. Such devices entail technologies ranging from artificial intelligence and computer-aided visualization technologies (software) to innovative molecular imaging modalities and surgical navigation (hardware). We discuss technologies based on their role at different steps of the surgical workflow, i.e., from surgical decision and planning, over to target localization and excision guidance, all the way to (back table) surgical verification. This provides a glimpse of how innovations from the technology fields can realize an exciting future for the molecular imaging and surgery communities.

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“…The use of mini C-arm fluoroscopy in orthopedic procedures has become increasingly popular due to its practicality, maneuverability, and cost-effectiveness. 23 Mini C-arm imaging provides temporal, anatomical information and real-time imaging of skeletal structures with the ability to confirm bony alignment and positioning as well as accurate placement of implants. 19,25,27 While the mini C-arm has many benefits, it is an additional piece of equipment in the OR with the potential for intraoperative contamination and, theoretically, surgical site infection (SSI).…”

Section: Introductionmentioning

confidence: 99%

Contamination of the Mini C-Arm During Foot and Ankle Surgery

et al. 2021

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Background: Many orthopedic surgeries utilize intraoperative fluoroscopy. The mini C-arm is an advantageous device as it can be easily used without the need for a dedicated radiology technician. However, there are concerns that the mini C-arm may represent a potential source of contamination and subsequent postoperative infection. Previous investigations of standard C-arm drapes have shown high rates of contamination. Similar contamination rates would be even more concerning for the mini C-arm as it requires physically maneuvering the machine. This study aimed to determine the rate of mini C-arm drape contamination and identify high-risk areas. Methods: Fifty foot and ankle surgeries requiring the use of mini C-arm fluoroscopy were included. Eight locations on the mini C-arm drape were sampled at the conclusion of each procedure. Culture Q-swabs were used for sampling defined locations. Swab samples were then assessed for bacterial growth on a 5% blood agar plate using a semiquantitative technique. Results: In 70% of surgical cases, contamination was observed in at least 1 location. Six of the 8 evaluated locations were found to have significantly higher contamination in comparison with their corresponding negative controls (Mann-Whitney U test, P < .05). The “outer portion of the upper arm” (location 1) exhibited bacteria growth in 26% ( P < .0001) of cases. The “superior portion of the x-ray source” (location 2) exhibited growth in 30% ( P < .0001) of cases. These were the highest-risk areas for contamination and were both significantly more likely to be involved than the “inferior portion of the x-ray source” and “superior portion of the beam receiver,” locations 4 and 5, respectively. Fourteen percent (7/50) C-arm cases and 1.72% (1/58) Achilles tendon surgery control cases developed surgical site infection ( P = .0234; OR, 9.27). Conclusion: Bacterial contamination of the mini C-arm drape was found to be common after foot and ankle procedures. Contamination was more prevalent on the outer ring areas of the C-arm, both at the emitter and receiver. Level of Evidence: Level III.

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C-arm fluoroscopy in orthopaedic surgical practice

Cited by 31 publications

References 41 publications

Arthroscopy-Assisted Management of Schatzker Type III Lateral Tibial Plateau Fracture With Interference Screw Fixation

Arthroscopy-Assisted Management of Schatzker Type III Lateral Tibial Plateau Fracture With Interference Screw Fixation

How molecular imaging will enable robotic precision surgery

Contamination of the Mini C-Arm During Foot and Ankle Surgery

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