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A-0630 Assessment of scaphoid fracture patterns using a 3D-CT model
Gernot Schmidle, Rohit Arora, Markus Gabl, Department for Trauma Surgery, Medical University Innsbruck, Innsbruck, Austria
Thursday, June 14, 2018 · 8:48 a.m. · 05m 34s
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missus sherman and dick leaks are happy not to talk about three d. scaffold fracture assessment
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after some background information about talk about our researches topic with the first study being
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a study 'cause comparing the ability of two d. and three d. imaging
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to an alliance sky a stability to know lice big tele t. and the fact that happens as a whole
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and the second study concerning with mel rotation of discomfort and mainly it's clinical relevance
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so what is our main goal our main goal is to tax discovery to heal and in the best
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case in an atomic position to avoid to long term consequences of pasta try to some pain
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and for that we need the imaging to really display the truth of the fracture
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the truth that we uh long to use for our indications for surgery
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and also to achieve then the favourably results we long for
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what is to the imaging able to do to the imaging gives us very good information
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about capping it gives of information about mel alignment in second so increment line
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it misses some fractal patterns it's not the complete picture as
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discovered itself is a three dimensional um uh stuff
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so the three d. imaging gives us now this ability to see all the fracture pens to
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penalise it very easy and fast without a lot of training maybe even and especially
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some parents liked rotational mel alignment this certain mention of no
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positioning is only visible in these three d. imaging methods
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so as a clinician i want to know which kind of imaging modality do i need to get the information necessary
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and for that we compare the sixty nine consecutive patients um fit with
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a forty five fractures in twenty four non unions in their ability
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to distinguish exactly those parameters and we started with the fact you
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get with the two d. c. t. b. no reference then
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and we saw that uh only forty nine percent of the x. rays were really getting it's the same information as
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to to d. c. t. so there was a gap of agreement more than in the three d. city
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but when we look at it threshold clinical relevant threshold that we use for the case
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surgery it was that lead it's one and the treatment in only
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eight point seven percent or two point nine percent respectively
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over treatment um as a surgeon is never a problem we treat it so
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fracture location now reviewed of with this three d. c. t. s. a reference
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standard showed that again the x. rays that's the worst agreement rates
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and it was especially true when the when more than one so it's involved in in the factor
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and when there was an involvement of the critical proximal poll so for these cases x-rays just not helpful
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and the part of the analysis of a three d. excels is when
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we go for the fact of course for the fractal plane
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that we see you know good uh agreement not needed for the x. rays no for the to the city
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and we see the coral plane being in fifty percent utterance was practically
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and in the secular plane we see in over seventy percent of the cases that
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the fractures nasty buttons thirty degrees and this is clinically valid rather relevant
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because the steeper dangle the harder it is to fix was the single screw it on the central axis
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one part we also ready this d. s. l. ligament um and especially that also attachment of it
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because as long as we have a soft tissue attachment to our proximal fragment
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some plots applies likely and we uh distinguished in in three regions
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the red rabbit we have a complete connection we have the red white and
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red uh and the white white somewhere there's possible on no connection
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and we saw that the fractures uh mainly the red rats and the non unions mainly in the red white and white white sounds
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i mean i'll go for the meditation uh we did a study
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in saudi seven patients but we analysed notation compared it
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to the treatment modality that we applied and to bone healing fracture h.
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we saw that the cases we treat its operative to operate to flee
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or that we treated conservatively but much lower no alignment rate
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and those that we could not we construct anymore so it somehow seems to be a measure of instability
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when we look for um and uh the healing rate itself it gives descriptive this the yeah distinguishing
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but the at the end uh two two little numbers to really give us significant values
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that's another case when we talk about factor age we saw
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that non unions have significantly higher rates of mel rotation
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so somehow to some extent it seems to be a part of the normal staff with a nonunion history
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but also fifteen percent of the prime rib fractures had not rotation of more than five degrees
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so to sum it up to somehow information um a three d. analyses gives us additional information that is it
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specially relevant when we go for treatment planning for pretty
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operative planning how to use our an implant
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and especially information about the fact of clean and its relation to anatomical relevant landmarks
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can give us additional information on stability but also on the vitality of the fragments
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and meditation is quite frequent and this frequency makes it's
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um more likely that we should address it
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to restore scaffold anatomy and so possible couple alignment
Conference Program
A-0267 Carpal Alignment: A New Method for Assessment
C.A. Selles 1, L. Ras 1, M.M.J. Walenkamp 1, M. Maas 2, J.C. Goslings 1, N.W.L. Schep 3, 1 Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands; 2 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands; 3 Department of Trauma and Hand Surgery, Maasstad Hospital, Rotterdam, the Netherland
June 14, 2018 · 7:59 a.m.
A-0267 Carpal Alignment: A New Method for Assessment - Q&A
June 14, 2018 · 8:05 a.m.
A-1076 The scapholunate gap increases with forearm supination. A laboratory study.
Mireia Esplugas 1, Guillem Salvà-Coll 2,3, Marc Garcia-Elias 4, Alex Lluch-Bergadà 4,5, Manuel Llusá-Pérez 6, Spain
June 14, 2018 · 8:07 a.m.
A-1076 The scapholunate gap increases with forearm supination. A laboratory study. Q&A
June 14, 2018 · 8:13 a.m.
A-0047 How Reliable is the Radiographic Diagnosis of Mild Madelung Deformity?
Sebastian Farr 1, Thierry G. Guitton 2, David Ring 3, Science of Variation Group, 1 Orthopedic Hospital Speising, Vienna, Austria; 2 University Medical Center, Groningen, The Netherlands; 3 Dell Medical School - The University of Texas, Austin, TX, USA
June 14, 2018 · 8:17 a.m.
A-0047 How Reliable is the Radiographic Diagnosis of Mild Madelung Deformity? Q&A
June 14, 2018 · 8:22 a.m.
A-0206 Comparison of Contact and Non-contact Ultrasound Examination of the Hand
Rebecca Lim 1, Chin Shu Ting 2, Chan Kai Li 2, Abby Choke 1, Tay Shian Chao 1,2, Duncan Angus McGrouther 1,2, 1 Department of Hand Surgery, Singapore General Hospital, Singapore; 2 Biomechanics Laboratory, Singapore General Hospital, Singapore
June 14, 2018 · 8:25 a.m.
A-0206 Comparison of Contact and Non-contact Ultrasound Examination of the Hand - Q&A
June 14, 2018 · 8:30 a.m.
A-0952 Contribution of ultrasound in the preoperative assessment of partial wrist denervation: an cadaveric and comparative study.
Vanessa costil, Thomas Apard, Ultrasound Surgery of the Hand, Private Hospital of Versailles, France
June 14, 2018 · 8:31 a.m.
135 views
A-0876 Diagnosis of hand and forearm fractures in whole body CT after polytrauma
Friederike Mu?nn 1, Andreas Eisenschenk 1,2, Martin Lautenbach 3, Tobias Topp 3, Simon Kim 1, Universitätsmedizin Greifswald, Germany; 2 Unfallkrankenhaus Berlin, Germany; 3 Krankenhaus Waldfriede Berlin, Germany
June 14, 2018 · 8:40 a.m.
A-0876 Diagnosis of hand and forearm fractures in whole body CT after polytrauma - Q&A
June 14, 2018 · 8:45 a.m.
A-0630 Assessment of scaphoid fracture patterns using a 3D-CT model
Gernot Schmidle, Rohit Arora, Markus Gabl, Department for Trauma Surgery, Medical University Innsbruck, Innsbruck, Austria
June 14, 2018 · 8:48 a.m.
297 views
