Intraoperative 3-Dimensional Imaging in Foot and Ankle Trauma-Experience With a Second-Generation Device (ARCADIS-3D)

Objective: Intraoperative 3-dimensional imaging with the first available device (ISO-C-3D; Siemens, Germany) has shown potential benefit in foot and ankle surgery. The aim of the study was to assess the clinical use of the second-generation device (ARCADIS-3D; Siemens) in comparison with earlier experience with the first-generation device. Methods: In a matched pair study, the ISO-C-3D/ARCADIS-3D was used for intraoperative visualization after reduction/correction and internal fixation. The ISO-C-3D was used in 62 cases between January 1, 2003, and March 15, 2004, and the ARCADIS-3D was used in cases with similar fractures and arthrodesis location between September 1, 2006, and April 30, 2008. Potentially, changes in implant position and/or reduction were made after device use. Time spent and changes resulting from the use of ISO-C-3D/ARCADIS-3D were registered and analyzed. Results: On average, the operation was interrupted for 440/320 seconds (ISO-C-3D/ARCADIS-3D), 120/60 seconds, on average, for the scan, and 210/180 seconds, on average, for evaluation of the images by the surgeon. In 39%/34% of the cases (24/21 of 62), the reduction and/or implant position was corrected during the same procedure after the ISO-C-3D/ARCADIS-3D scan. Conclusions: intraoperative 3-dimensional visualization with the ISO-C-3D/ARCADIS-3D can provide useful information that cannot be obtained from plain films or conventional C-arms. The second-generation device (ARCADIS-3D) provides faster scan and evaluation that reduces time spent. No other benefits were seen.