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1000 Titel
  • Intraoperative 3D imaging in intraarticular tibial plateau fractures - Does it help to improve the patients’ outcomes?
1000 Autor/in
  1. Souleiman, Firas |
  2. Henkelmann, R. |
  3. Theopold, J. |
  4. Fakler, J. |
  5. Spiegl, U. |
  6. Hepp, P. |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-05-05
1000 Erschienen in
1000 Quellenangabe
  • 16(1):295
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13018-021-02424-3 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097962/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!In tibial plateau fractures (TPF) the restoration of an anatomical joint surface as well as an exact subchondral screw position for postoperative stability is crucial for the outcome. The aim of this study was to determine whether the additional use of an intraoperative 3D imaging intensifier (3D) might help to improve the outcome of complex TPF.!##!Methods!#!We performed a retrospective case-control study of a level 1 trauma center. Patients with AO/OTA 41 B3 and C-TPF operated on using a 3D imaging intensifier between November 2015 and December 2018 (3D group) were included. The outcomes of this patients were compared to patients operated without 3D imaging between January 2005 to December 2014 (2D group). The comparison of the groups was performed by matched pair analysis. The functional outcome of both groups was measured by KOOS and Lysholm Score after a follow-up period of at least 12 months. Operation time, infections and postoperative revisions were registered.!##!Results!#!In total, 18 patients were included in the 3D group (mean age: 51.0± 16.4 years; 12 females) and an equal number of matching partners from the 2D group (mean age: 50.3± 15.2 years; 11 females) were found (p=0.82; p=0.79). We found 9x B3, 2x C1, 1x C2, 6x C3 fractures according to AO/OTA for each group (p=1.00) with comparable ASA score (p=0.27). The mean operation time was 127.9± 45.9 min and 116.1± 45.7 min for the 3D and 2D group (p=0.28). The mean follow-up time was 20.9± 10.7 months for the 3D and 55.5± 34.7 months for the 2D group (p< 0.001). For the 3D group a mean Lysholm overall score of 67.4± 26.8 and KOOS overall score of 72.6± 23.5 could be assessed. In contrast, a mean Lysholm overall score of 62.0± 21.4 and KOOS overall score of 65.8± 21.6 could be measured in the 2D group (p=0.39; p=0.31). Thereby, functional outcome of the 3D group showed a significant higher KOOS Sport/Rec sub score of 54.7± 35.0 in comparison to the 2D group with 26.7± 31.6 (p= 0.01). Postoperative revisions had to be performed in 27.8% of cases in both groups (p=1.00). Due to the 3D imaging an intraoperative revision was performed in 33.3% (6/18).!##!Conclusion!#!In our study we could show that re-reduction of the fracture or implant re-positioning were performed in relevant numbers based on the 3D imaging. This was associated with a midterm clinical benefit in regard to better KOOS Sport/Rec scores.!##!Trial registration!#!AZ 488 /20-ek.
1000 Sacherschließung
lokal fluoroscopy
lokal Aged [MeSH]
lokal ORIF
lokal Tibial Fractures/surgery [MeSH]
lokal Tibial plateau fracture
lokal Male [MeSH]
lokal Fracture Fixation/methods [MeSH]
lokal Case-Control Studies [MeSH]
lokal Imaging, Three-Dimensional/methods [MeSH]
lokal Research Article
lokal Reoperation/statistics
lokal Female [MeSH]
lokal Outcome
lokal Follow-Up Studies [MeSH]
lokal Recovery of Function [MeSH]
lokal Tibial Fractures/physiopathology [MeSH]
lokal Adult [MeSH]
lokal Humans [MeSH]
lokal Treatment Outcome [MeSH]
lokal infection
lokal Retrospective Studies [MeSH]
lokal 2D imaging
lokal Middle Aged [MeSH]
lokal Surgery, Computer-Assisted/methods [MeSH]
lokal Time Factors [MeSH]
lokal revision rate
lokal 3D imaging
lokal Operative Time [MeSH]
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0003-1087-7503|https://frl.publisso.de/adhoc/uri/SGVua2VsbWFubiwgUi4=|https://frl.publisso.de/adhoc/uri/VGhlb3BvbGQsIEou|https://frl.publisso.de/adhoc/uri/RmFrbGVyLCBKLg==|https://frl.publisso.de/adhoc/uri/U3BpZWdsLCBVLg==|https://frl.publisso.de/adhoc/uri/SGVwcCwgUC4=
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