Purpose
This study attempted to determine the clinical effectiveness of the intraoperative
use of 3-dimensional fluoroscopy compared with conventional 2-dimensional fluoroscopy
in patients with distal radius fractures.
Methods
We performed a multicenter randomized clinical trial in which 206 patients were randomized
between the use of 3-dimensional fluoroscopy or not during operative treatment of
the distal radius fracture. The primary outcome was the quality of fracture reduction
and fixation assessed on a postoperative computed tomography scan with a dichotomous
outcome: indication for revision, yes or no.
Results
There was no significant difference in whether the fracture required revision surgery:
31% (2-dimensional group) versus 24% (3-dimensional group). In 11% of distal radius
fractures allocated to the 3-dimensional group, additional intraoperative corrections
(screw replacements) were performed.
Conclusions
Compared with 2-dimensional fluoroscopy, the use of intraoperative 3-dimensional fluoroscopy
does not appear to improve the quality of reduction and fixation in the management
of patients with a distal radius fracture. However, the use of 3-dimensional fluoroscopy
appears to have advantages such as more intraoperative revisions and less revision
surgeries that this study could not clearly demonstrate.
Type of study/level of evidence
Diagnostic II.
Key words
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Article info
Publication history
Published online: January 16, 2020
Accepted:
November 6,
2019
Received:
November 20,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
