Comparison of intraoperative 2D vs. 3D imaging in open reduction and fixation of distal radius fractures

Purpose In the volar plating of distal radius fractures, intraoperative three-dimensional (3D) imaging is designed to allow better judgment regarding screw and implant positioning compared with conventional intraoperative two-dimensional (2D) imaging. We evaluated the impact of these two imaging modalities on the rates of intraoperative revision and secondary surgery, as well as the need for implant removal during follow-up. Methods A retrospective analysis of consecutive patients who underwent volar plate osteosynthesis for isolated distal radius fractures between January 2008 and April 2016 was performed. Patient files were evaluated for intraoperative imaging findings, intraoperative and postoperative revision rates, and implant removal during follow-up. Additional analyses of radiation exposure, operation time, and hospitalization time were performed. Results A total of 314 patients were analyzed (mean age: 54 ± 19 years; 210 females). For 246 patients, only 2D imaging was performed, while the remaining 68 patients underwent both 2D and 3D imaging (O-Arm, Medtronic). The intraoperative revision rate was significantly ( p