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A-0759 Analysis of interfragmentary motion in scaphoid fractures by 4-dimensional computed tomographic imaging
Marieke GA de Roo 1,2, Johannes GG Dobbe 2, Geert J Streekstra 2, Simon D Strackee 1, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, the Netherlands
Thursday, June 14, 2018 · 9:16 a.m. · 04m 12s
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alright so the second sock uh about into fragmentary motion escape which direction for d. c. t. imaging
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uh first in short a script which structure a ten percent guesses to skate with mine union and we all
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know the factors are associated with the development work let's buy faction displacement structure instability in part in speech
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but especially this fracture instability it's kind of
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difficult to assess instability on setting imaging
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uh and therefore with for d. c. t. we can know analyst is in v. phone
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and therefore we started a trial a prospective trial which we include patient with
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one side escape with non union we hadn't been operated on one
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um and we looked at the position of the fracture line 'cause it's stated in nature that if the position of the fracture
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line once this all to the door so apex of this k.
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for it you would have a in stable skateboard fragments
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and if it runs proximal to the doors apex of the skateboard uh you
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would have more uh you would have less motion between the two fragment
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therefore the purpose of this research was to one to five it's cable track
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instability depends on the position of the fracture line relative to this eight
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what we get is a week as i told include patient first
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uh the lady a prone position would have extended forward
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in this positioning device we scan with if it is really c. t. scan em first take a step they uh
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a three d. c. t. high resolution scan then we that they should move to release in ten seconds
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from extension to flexion or from radio to only mission uh in which they tried to move show
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then from this data uh we started process paul segmentation so from the high resolution spam uh we
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can uh make word outlines of the bones and then you get a new entry particles
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then you fit is ball gowns into the forty nine frames these are approximately four hours a third time right
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um and then when you fit them uh we evaluate our research and uh
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we have neck received two meeting your translation in one degree rotation
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then what do we do we look at the red motion of the digital fragment to the proximal fragment
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uh as shown here and this is expressed in the morning system i'm just talking about
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uh that till now include eleven patients for patients with fractional i'm proximal to da
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act and stuff and patient with the fraction line does not escape it
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um then yeah those
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it's it's so here you see uh the motion of the diesel fragment relative to the proximal fragment
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and you see you have a very working stable with a lot of motion between effect and
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such as this one but you also see that some have relatively little motion as here
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but you can also one five is so that's what we get um and i will take you through this prof of what
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you see here on the y. axes is the amount of fragment rotation from the this effect into the proximal fragment
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on the x. axis you see the global wrist motion uh and we use the kept its motion as clovis motion
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the minus is a extra zero neutral to flexion the red hot spots are those with the french line
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distilled escape with apex and the blue box but also to the proximal a fraction approximately eight that
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you seen extension that uh from extension to zero uh there's not
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that big difference but if you move from zero to flexion
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it seems like that of those with the fracture line distal to the apex open up more and there's more motion
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however you see that that intervals of these box plots are very wild
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uh and we did not find any statistically significant differences yes
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uh there for for now we say that it's pretty still patients specific you
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cannot say that if defection lines on this so it's always been stable
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uh and we also like to say that for e. c. t. scanning is accurate
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