A P R I L 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 6 1
a 2D image, it's difficult to see
that you've get the bones lined
up right. A malreduced syn-
desmosis results in worse
long-term functional outcomes
and traditionally has been best
assessed with a post-operative
CT scan. Revision of the
reduction would require a sec-
ond anesthesia and surgery.
Having CT-like technology in
the OR is the best way to
assess the reduction and make
an adjustment. Similarly, my
spine surgeon colleagues have
shared with me that they can
detect and correct pedicle
screw misplacements intraoperatively with 3D C-arm imaging.
In addition to eliminating post-op scans, 3D C-arms can also create efficien-
cies in the emergency room. Instead of forcing fracture patients, for example, to
wait for an X-ray in radiology and then sit around for test results, we can bring
them right to the OR and scan them there.
You can easily position the C-arm during all kinds of procedures and effortless-
ly roll it from one room to another (I would use the 3D C-arm in every cases if I
could, but that'd be overkill). 3D C-arms might also let you shrink your surgical
footprint, letting you make reductions with smaller incisions or even doing so
percutaneously. For example, imagine being able to assess a fracture within the
joint cartilage without direct visualization. This added functionality is why there
is great potential for 3D C-arms to be a disruptive technology.
• CONFIRMATION The 3D image shows fixation of an acetabular fracture with
columnar screws. The image demonstrates acceptable reduction and that the
implants are extra-articular and correctly positioned within the bone.
Joshua
L.
Gary,
MD
