Detection of articular perforations of the proximal humerus fracture using a mobile 3D image intensifier – a cadaver study

Jan Theopold, Kevin Weihs, Christine Feja, Bastian Marquaß, Christoph Josten, Pierre Hepp
2017 BMC Medical Imaging  
The purpose of this study was to investigate the accuracy of perforation detection with multiplanar reconstructions using a mobile 3D image intensifier. Methods: In 12 paired human humeri, K-wires perforating the subchondral bone and placed just below the cartilage level were directed toward five specific regions in the humeral head. Image acquisition was initiated by a fluoroscopy scan. Within a range of 90°, 45°external rotation (ER) and 45°internal rotation (IR). The number and percentage of
more » ... detected perforating screws were grouped and analyzed. Furthermore, the fluoroscopic images were converted into multiplanar CT-like reconstructions. Each K-wire perforation was characterized as "detected" or "not detected". Results: In the series of fluoroscopy images in the standard neutral position at 30°internal rotation, and 30°external rotation, the perforations of all K-wires (n = 56) were detected. Twenty-nine (51.8%) of them were detected in one AP view, 22 (39.3%) in two AP views, and five (8.9%) in three AP views. All K-wire perforations (100%, n = 56) were detected in multiplanar reconstructions. Conclusion: In order to reveal all of the intraoperative and postoperative screw perforations in a "five screw configuration", conventional AP images should be established in both the neutral positions (0°), at 30°internal rotation and 30°external rotation. Alternatively, the intraoperative 3D scan with multiplanar reconstructions enables a 100% rate of detection of the screw perforations.
doi:10.1186/s12880-017-0201-0 pmid:28764643 pmcid:PMC5540431 fatcat:73bfhahqtbempipd5r6yakxcnq