{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:22:46Z","timestamp":1788823366091,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n To evaluate whether the use of intraoperative 3D fluoroscopy during acetabular fracture fixation reduces the rate of unplanned returns to the operating room and improves radiographic quality of reduction without increasing operative time or blood loss.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective comparative study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Single urban Level I trauma center.<\/jats:p>\n <\/jats:sec>\n \n Patient Selection Criteria:<\/jats:title>\n Patients with operatively treated acetabular fractures (OTA\/AO 62) between 2017 and 2025. Patients were divided into 2 cohorts: those treated before and after the implementation of intraoperative 3D fluoroscopy (Cios Spin, Siemens, Germany).<\/jats:p>\n <\/jats:sec>\n \n Outcome Measures and Comparisons:<\/jats:title>\n Primary outcome was the rate of unplanned return to the operating room. Secondary outcomes included postoperative residual joint gap, presence of intra-articular loose bodies, implant malposition, operative time, and estimated blood loss (EBL). These outcomes were compared between the 2 cohorts.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n 177 patients were included between 2017 and 2025, 148 patients treated before (control group) and 29 after the implementation of intraoperative 3D fluoroscopy (3D fluoro group). The mean age as 41.1 \u00b1 17.4 years in the control group with 117 men (79%) versus 42.8 \u00b1 18.1 years (\n P<\/jats:italic>\n = 0.55) in the 3D fluoro group, with 20 men (68.9%,\n P<\/jats:italic>\n = 0.34). The rate of unplanned return to the operating room was significantly lower in the 3D fluoroscopy group (0%) compared with the control group (15.5%) (\n P<\/jats:italic>\n = 0.01). Postoperative CT scan (obtained in 148\/148 in the control group and 22\/29 in the 3D fluoroscopy group) demonstrated better fracture reduction in the 3D fluoroscopy group (mean residual gap: 3.4 \u00b1 1.9 mm vs. 4.5 \u00b1 2.4 mm;\n P<\/jats:italic>\n = 0.03). There were no significant differences in operative time (200.6 \u00b1 99.8 vs. 221.2 \u00b1 114.4;\n P<\/jats:italic>\n = 0.49) or EBL (641.6 \u00b1 637.1 vs. 674 \u00b1 572;\n P<\/jats:italic>\n = 0.67) between groups. Intraoperative findings seen on the 3D fluoroscopy such as malreduction, loose bodies, or misplaced hardware led to modification of the surgical plan in 29% of cases where the 3D fluoroscopy was used.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n The use of intraoperative 3D fluoroscopy allowed intraoperative identification and correction of malreductions, implant malposition, and removal of loose bodies, reducing the need for revision surgery and improving quality of reduction in acetabular fracture fixation. Its use did not increase operative time or blood loss, suggesting clinical and potentially economic benefits that may support broader adoption.<\/jats:p>\n <\/jats:sec>\n \n LEVEL OF EVIDENCE:<\/jats:title>\n Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000003100","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T13:02:56Z","timestamp":1760446976000},"page":"119-123","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Intraoperative 3D Fluoroscopy Reduces Revision Rates and Improves Reduction Quality in Acetabular Fracture Fixation"],"prefix":"10.1097","volume":"40","author":[{"given":"Marie","family":"Le Baron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"David","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron A.","family":"Ward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2132-3418","authenticated-orcid":false,"given":"Cyril","family":"Mauffrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20260213","first-page":"558","article-title":"A comprehensive estimation of the costs of 30-Day postoperative complications using actual costs from multiple, diverse hospitals","volume":"46","author":"Merkow","year":"2020","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"R2-20260213","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1186\/s13018-024-04814-9","article-title":"Evaluating the risk of return to the operating room across all elective orthopaedic procedures","volume":"19","author":"Kiritsis","year":"2024","journal-title":"J Orthop Surg Res"},{"key":"R3-20260213","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s13741-021-00218-z","article-title":"Readmissions after elective orthopedic surgery in a comprehensive co-management care system-a retrospective analysis","volume":"10","author":"Rohrer","year":"2021","journal-title":"Perioper Med"},{"key":"R4-20260213","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/BOT.0000000000002727","article-title":"Postoperative computed tomography scans of acetabular fractures routinely identify indications for revision surgery","volume":"38","author":"Kim","year":"2024","journal-title":"J Orthop Trauma"},{"key":"R5-20260213","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1007\/s00590-022-03284-1","article-title":"Complications after surgical treatment of acetabular fractures: a 5-year follow-up of 229 patients","volume":"33","author":"Lundin","year":"2023","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"R6-20260213","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1186\/s12891-023-06977-8","article-title":"Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients","volume":"24","author":"Enocson","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"R7-20260213","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s00402-007-0411-y","article-title":"Value of 3D fluoroscopic imaging of acetabular fractures comparison to 2D fluoroscopy and CT imaging","volume":"128","author":"Kendoff","year":"2008","journal-title":"Arch Orthop Trauma Surg"},{"key":"R8-20260213","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000002686","article-title":"Use of 3D fluoroscopy to assist in the reduction and fixation of pelvic and acetabular fractures: a safety and quality case series","volume":"37","author":"Warner","year":"2023","journal-title":"J Orthop Trauma"},{"key":"R9-20260213","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1097\/01.bot.0000202388.32623.56","article-title":"Fractures of the acetabulum: a study of a series of 75 cases\u2014Les fractures du cotyle, etude d\u2019une serie de 75 cas. 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