The evolution of 3D imaging in orthopedic trauma care

Three-dimensional (3D) imaging can enhance trauma care by allowing better evaluation of bony detail and implant position compared to conventional fluoroscopy or x‑ray. Intraoperative 3D imaging further improves this evaluation by allowing any necessary revisions to be made in the operating room prior to the patient emerging from anesthesia. This revision, if necessary, better achieves the surgical goals and alleviates the stressful situation of obtaining postoperative 3D imaging, where the benefit of revision must be balanced against the cost and risk of returning to the operating room. Improved image volume, resolution, and software capability have allowed surgeons to obtain high-quality, wide field views of bony anatomy that can include the uninjured side as a comparison. In this paper, the evolution of intraoperative 3D imaging over the past 25 years is discussed.ZusammenfassungDurch dreidimensionale (3-D-)Bildgebung kann die Versorgung von Verletzungen verbessert werden, weil im Vergleich zur konventionellen Durchleuchtung oder Röntgenaufnahme eine genauere Beurteilung knöcherner Details und der Position von Implantaten möglich ist. Die intraoperative 3‑D-Bildgebung steigert diese Verbesserung noch, da sie notwendige Revisionen im Operationssaal ermöglicht, bevor der Patient aus der Narkose aufwacht. Mit einer solchen Revision, falls erforderlich, werden die Ziele des Eingriffs besser erreicht und die mit Stress verbundene Situation der Erlangung postoperativer 3‑D-Aufnahmen vermieden, bei der sowohl der Nutzen einer Revisionsoperation als auch die Kosten und Risiken einer Rückkehr in den Operationssaal abgewogen werden müssen. Verbesserungen im Bereich des Bildvolumens, der Auflösung und der Leistungsfähigkeit der Software ermöglichen es den Chirurgen, hochwertige, großflächige Darstellungen der knöchernen Anatomie zu erhalten, wozu auch die unverletzte Seite als Vergleich gehören kann. In der vorliegenden Arbeit wird die Entwicklung der intraoperativen 3‑D-Bildgebung im Lauf der letzten 25 Jahre erörtert.

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