Intraoperative fluoroscopy to evaluate fracture reduction and hardware placement during acetabular surgery

Objectives: To evaluate use of intraoperative fluoroscopy during acetabular surgery to determine fracture reduction and accurate placement of screws. Design: Retrospective. Setting: Level I trauma center. Participants: Thirty patients with thirty-two acetabular fractures. Intervention: Patients were evaluated with fluoroscopy during surgery to as sess fracture reduction and screw placement. Anterior-posterior (AP), obliq ue, and lateral pelvic fluoroscopic images were obtained intraoperatively. Postoperative radiographs were used to-verify fluoroscopic findings; comput ed tomography (CT) scans were used as the control to assess intraarticular screw placement. Main Outcome Measurements: Radiographic and clinical assessment of fracture reduction and screw placement. Results: Intraoperative fluoroscopy confirmed the extra-articular position of all screws evaluated. Postoperative CT scans confirmed the extra-articul ar placement of all screws assessed by fluoroscopy. Quality of reduction us ing intraoperative fluoroscopic images had a 100 percent correlation with r eduction on final radiographs. One patient, with two screws: placed without fluoroscopic evaluation, had intra-articular placement requiring revision surgery. Conclusions: Intraoperative fluoroscopy is effective in evaluating both ace tabular fracture reduction and hardware placement.