Comparative analysis of the quality of mobile C-arm three-dimensional imaging of the talus

Malposition of extraosseous or intra-articular screws, e.g., in osteosynthe ses of joint fractures or in the vicinity of joints, frequently remains und iscovered in intraoperative fluoroscopy and is only recognized on postopera tive computed tomography (CT) scans. The aim of the study, therefore, was t o assess the value of a new mobile C-arm three-dimensional imaging device i n comparison with fluoroscopy, conventional radiographs, and CT scans using an extremity model. Screws were inserted ventrally in four anatomic lower leg specimens without talus fractures parallel to the longitudinal axis to simulate surgical man agement of fractures of the talus. The specimens supplied were examined wit h fluoroscopy, conventional radiography, spiral CT, and the new three-dimen sional imaging with the SIREMOBIL Iso-C-3D. These four modalities were eval uated by ten radiologists and ten trauma surgeons and were compared regardi ng subjective image quality and position of the screws. The quality of information acquired with the SIREMOBIL Iso-C-3D was equal t o that of the CT examinations, although image quality was considered inferi or to fluoroscopy, conventional radiography, and CT (p <0,001). In contrast to the previous procedure with intraoperative fluoroscopy and subsequent p ostoperative X-ray control,the results obtained with the SIREMOBIL IsoC(3D) were superior. The SIREMOBIL Iso-C-3D is useful for the intraoperative diagnosis of small joints with few artifacts producing osteosynthesis material, i.e., for reco gnizing the position of screws in the region of glenoid surfaces.