Comparison of Intraoperative C-Arm Fluoroscopy to Postoperative Radiographs in Operative Fracture Fixation

The purpose of this study is to evaluate the differences between intraoperative C-arm images and
postoperative plain film radiographs and the utility of each in assessing fracture fixation and determining
postoperative management. Intraoperative and postoperative images with varying fracture types and
locations were analyzed. C-arm images were compared to postoperative plain film radiographs for
each treated fracture and reviewed by two orthopaedic surgeons. Image adequacy and quality for each
radiograph were analyzed. The quality of reduction and fixation was also analyzed. Information was
apparent on the postoperative radiographs, such that a reviewer felt that the postoperative treatment
plan should change in 8.2% of cases. In the cases where treatment change was recommended, fracture
gap, rotation, and angulation were found to be the strongest predictors. The ability of intraoperative and postoperative images to reflect fracture gap, rotation, and angulation may vary between images. (Journal of Surgical Orthopaedic Advances 24(3):180–183, 2015)

Key words: fracture management, imaging