gms | German Medical Science

Objectives: This study examines the effects of intraoperative mobile 2D/3DX imaging system (O-arm) on the reduction quality and functional recovery of Acetabular dome impaction fractures (ADIF)

Methods: A retrospective analysis of the data of 48 patients with ADIF treated in Honghui Hospital from October 2018 to October 2021 was conducted. According to the intraoperative reduction quality assessment method, 25 cases in the X-ray group and 23 cases in the O-arm group. Residual step-off and gap displacements in the acetabular dome region were measured and the quality of postoperative fracture reduction was evaluated according to the reduction criteria described by Verbeek and Moed et al. Hip function was also evaluated according to the modified Merle d'Aubigné and Postel scoring system at the last follow-up.

Results and conclusion: There was no significant difference in preoperative general data between the two groups (P>0.05). In the X-ray group,the residual average step displacement in the acetabular dome region was 3.4±2.3mm, and the gap displacement was 6.7±3.5mm. In the O-arm group, the residual average step displacement in the acetabular dome region was 1.5±1.0 mm (<0.05), and the gap displacement was 3.8±1.5 mm (P<0.05). In the X-ray group, according to the fracture reduction criteria described by Verbeek and Moed et al., 1 case was excellent, 12 cases were good, 12 cases were poor, and the rate of excellent and good was 52%; in the O-arm group, 7 cases were excellent, 12 cases were good, and 4 cases were poor, and the rate of excellent and good was 82.6% (P<0.05). Nineteen patients were followed up, and according to the modified Merle d'Aubigné and Postel functional score at the last follow-up, six cases were excellent, 10 cases were good, two cases were fair, and one case was poor, with a good to excellent rate of 84.2%. Operation time and intraoperative blood loss were increased in the O-arm group, and there were statistical differences between the two groups (P<0.05).2 patients lost follow-up, 46 patients gained follow-up, fracture healing, X-ray group at the last follow-up according to the modified Merle d 'Aubigne & Postel function score: excellent 3 cases, good 12 cases, good 6 cases, poor 3 cases, excellent good rate of 62.5%, O-arm group: excellent 9 cases, good 10 cases, fair 2 cases, poor 1 case, The excellent and good rate was 86.4% (P<0.05). Application of O-arm in ADIF can have a positive impact on the improvement of fracture reduction quality and functional recovery.