Intraoperative 3D rotational X-ray in wrist surgery: initial experiences

It is generally accepted that an accurate anatomical reconstruction of the hand/wrist joint is a basis for optimal outcome in reconstructive wrist surgery. The reported complication rate for reconstruction surgery of the wrist based on postoperative radiological results can be up to 23% [1 4]. Conventional C-arm fluoroscopy for hand surgery frequently fails to reveal suboptimal positioning of implants, insufficient reconstructions and joint incongruities. The non-standard positioning of the hand and wrist, the angle of imaging, and the low definition caused by overprojection limit the value of intraoperative fluoroscopy [5 8]. Consequently, these imperfections often remain undetected until after the procedure, and are only recognized on standardized radiographs and postoperative Computed Tomography (CT) scans [5, 6, 9].