Background: The purpose of this study is to evaluate the applicability and advantages of the intraoperative use of a mobile isocentric C-arm with 3-dimensional imaging (SIREMOBIL ISO-C-3D) in trauma surgery.

Patients & Methods: Between November, 2004 and September, 2005, the ISO-C-3D was used at our institution for intraoperative CT-quality visualization of 33 trauma cases with the fractures of calcaneus (13), tibial plateau (7), tibial plafond (6), acetabulum (4), distal radius (2) and talus (1). The mean patient age was 42 and male to female ratio 25 to 8. In 30 cases ISO-C-3D was used during the surgery after the reduction and fixation of the fracture to assess the accuracy of reduction and implant position prior to wound closure and in 3 cases the device was used before starting the operation to obtain real-time CT images which were transferred to a navigation system to perform computer navigated procedures.

Results: This novel technique was highly beneficial from 4 aspects; intraoperative diagnosis, proper reduction, correct implant placement and feasibility in combining the CT images to computer navigation. In 40% of the cases (13/33) who had no regular CT scan before the surgery, intraoperative three dimensional imaging with ISO-C-3D has been a superior modality in diagnosis. In one case the reduction and implant position was corrected during the surgery after the ISO-C-3D scan. In all the procedures with ISO-C-3D navigation, satisfactory reconstruction of the articular surfaces with precise fixation was achieved.

Conclusion: Intraoperative 3-dimensional visualization with ISO-C-3D provides useful information in trauma surgery which enables the surgeon to re-evaluate the injury diagnostically and to judge the reduction and implant position before wound closure. Combining the ISO-C-3D images with computer navigation makes the reduction and implant placement highly accurate.