Comparison of 2D and 3D fluoroscopy for intraoperative detection of intra-articular incongruities in distal radius fractures
Background Insufficient reduction of intra-articular fractures can lead to posttraumatic arthritis. An accurate intraoperative assessment of the articular surface is essential to guide surgical decision-making. This study aims to compare the sensitivity of 2D and 3D fluoroscopy for detecting intra-a...
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| Hauptverfasser: | , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
23 September 2025
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| In: |
Journal of orthopaedic surgery and research
Year: 2025, Jahrgang: 20, Heft: 1, Pages: 1-10 |
| ISSN: | 1749-799X |
| DOI: | 10.1186/s13018-025-06284-z |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1186/s13018-025-06284-z Verlag, kostenfrei, Volltext: https://link.springer.com/article/10.1186/s13018-025-06284-z 
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| Verfasserangaben: | Fenna Brunken, Benno Bullert, Paul A. Grützner, Sven Y. Vetter and Nils Beisemann |
| Zusammenfassung: | Background Insufficient reduction of intra-articular fractures can lead to posttraumatic arthritis. An accurate intraoperative assessment of the articular surface is essential to guide surgical decision-making. This study aims to compare the sensitivity of 2D and 3D fluoroscopy for detecting intra-articular gaps and step-offs in distal radius fractures. Methods Intra-articular distal radius fractures were induced in 6 cadaveric forearms and intra-articular incongruities(gap/step-off ) of 0, 1 and 2 mm were created using 3D-printed repositioning guides. Images were acquired by 2D and 3D fluoroscopy for each step and evaluated by 3 blinded observers. Sensitivity and specificity for the detection of intra-articular incongruities were analyzed. Additionally, the inter-rater agreement for the decision to perform revision surgery and dose area product (DAP) were evaluated. Results The overall sensitivity of 3D fluoroscopy for the detection of intra-articular incongruities was 90.28% compared to 55.56% for 2D fluoroscopy. Sensitivities for the detection of 2 mm incongruities were higher than for 1 mm especially in 2D fluoroscopy (1 mm: 38.89%; 2 mm: 74.72%). In 41.67% of cases with 1 mm incongruities where no revision was deemed necessary in 2D fluoroscopy, 3D imaging prompted a change in decision to perform revision. The dose area product was significantly higher for 3D fluoroscopy (41.87 cGycm2) compared to 2D fluoroscopy (3.13 cGycm2) (p < 0.0001).Conclusion The results suggest that 3D fluoroscopy can facilitate the detection of intra-articular incongruities in distal radius fractures and may prompt intra-operative revisions. Further clinical studies are needed to determine the effect on surgical outcomes. |
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| Beschreibung: | Gesehen am 20.01.2026 |
| Beschreibung: | Online Resource |
| ISSN: | 1749-799X |
| DOI: | 10.1186/s13018-025-06284-z |