• J Franke, J von Recum, K Wendl, and P A Grützner.
• MINTOS - Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Unfallchirurgische Klinik an der Ruprecht-Karls-Universität Heidelberg, AGiTEC - Arbeitsgemeinschaft für intraoperative Bildgebung und Technologie Integration der DGOU, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Deutschland. jochen.franke@bgu-ludwigshafen.de
• Unfallchirurg. 2013 Feb 1; 116 (2): 185-90.

BackgroundWith reference to two large retrospective studies we would like to make a contribution to the discussion whether intraoperative 3-dimensional imaging is only a helpful tool or state of the art for some special indications.MethodsTo answer this question the intraoperative revision rates of syndesmotic injuries and calcaneal fractures were analyzed over a period of 10 years and 8 years, respectively. Additionally, the clinical outcome was evaluated depending on the restoration of the joint reconstruction.ResultsIntraoperative revision rates of 32.7 % of 251 syndesmotic injuries and 40.3 % of 377 calcaneal fractures were found. The mutivariate analysis showed that residual joint incongruity leads to significantly worse clinical and radiological outcome of calcaneal fractures.ConclusionsCorrect assessment of alignment and joint line reconstruction are not possible by means of fluoroscopy in every case of syndesmotic injuries and calcaneal fractures. Therefore, intraoperative 3-dimensional imaging should be used in the treatment of these injuries due to the high intraoperative revision rates and the clinical relevance.

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