intraoperative imaging with cios select fd
TRANSCRIPT
![Page 1: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/1.jpg)
1Unrestricted © Siemens Healthineers, 2019Unrestricted © Siemens Healthineers, 2019
Clinical Cases – Ortho Trauma
Intraoperative Imaging with Cios Select FD
BG Trauma Center Ludwigshafen, Germany
![Page 2: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/2.jpg)
2Unrestricted © Siemens Healthineers, 2019
Clinical Cases
• Acetabulum
• Clavicula
• Femur
• Humerus distal
• Tibia
• Tibia plateau
• Conclusion
Advanced Therapies | AT-19-141
![Page 3: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/3.jpg)
3Unrestricted © Siemens Healthineers, 2019
Clinical Case
Acetabulum
Advanced Therapies | AT-19-141
Back tocontent slideclinical cases
![Page 4: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/4.jpg)
4Unrestricted © Siemens Healthineers, 2019
Intraoperative imaging with Cios Select FDClinical case – Acetabulum
• Background pathology
• Background therapy
• Patient history
• Preoperative findings
• Surgical procedure
AP viewAlar/oblique view
Advanced Therapies | AT-19-141
![Page 5: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/5.jpg)
5Unrestricted © Siemens Healthineers, 2019
Background pathology
AO ClassificationAcetabular fracturesTypes:Pelvis, acetabulum, partial articular, isolated column and/or wall fracture62A
Pelvis, acetabulum, partial articular, transverse type fracture62B
Pelvis, acetabulum, completearticular, associated both columnfracture62C
Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
Advanced Therapies | AT-19-141
![Page 6: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/6.jpg)
6Unrestricted © Siemens Healthineers, 2019
Background therapy
Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
ORIFFixation of the iliac wing and plate fixation of the anterior column
Advanced Therapies | AT-19-141
![Page 7: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/7.jpg)
7Unrestricted © Siemens Healthineers, 2019
Patient history
Classification: Complex acetabular fracture with central hip protrusion and pelvic fracture
Remarks:• Skiing accident• Initial extension treatment• Pain in right pelvic region• No peripheral motorical or neurological
deficits
Gender male
Age 46 - 60
Advanced Therapies | AT-19-141
![Page 8: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/8.jpg)
8Unrestricted © Siemens Healthineers, 2019
8Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative CTAxial, sagittal and coronal view of pelvis
• Complex acetabular fracture with central hip protrusion and pelvic fracture on the right
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 9: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/9.jpg)
9Unrestricted © Siemens Healthineers, 2019
9Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingPelvis and right hip in AP view
• Regular articulation of the hip joint• Symphysis and right ISG joint are in anatomically regular
position
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 10: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/10.jpg)
10Unrestricted © Siemens Healthineers, 2019
10Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingPelvis and right hip in AP view
• Correct implant positioning• Good bony contrast in spite of metal objects• No intra-articular fragments or screw penetration
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 11: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/11.jpg)
11Unrestricted © Siemens Healthineers, 2019
11Unrestricted © Siemens Healthineers, 2019
Surgical procedureAlar/ oblique view
Intraoperative imagingPelvis and right hip in alar/oblique view
• Correct implant positioning• Regular articulation of the hip joint
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 12: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/12.jpg)
12Unrestricted © Siemens Healthineers, 2019
12Unrestricted © Siemens Healthineers, 2019
Surgical procedureAlar view
Intraoperative imagingPelvis and right hip in alar/oblique view
• Correct implant positioning• No intra-articular fragments or screw penetration
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 13: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/13.jpg)
13Unrestricted © Siemens Healthineers, 2019
Clinical Case
Clavicula
Advanced Therapies | AT-19-141
Back tocontent slideclinical cases
![Page 14: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/14.jpg)
14Unrestricted © Siemens Healthineers, 2019
Intraoperative imaging with Cios Select FDClinical case – Clavicula
• Background pathology
• Background therapy
• Patient history
• Preoperative findings
• Surgical procedure
AP viewAxial view
Advanced Therapies | AT-19-141
![Page 15: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/15.jpg)
15Unrestricted © Siemens Healthineers, 2019
Background pathology
Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
AO ClassificationTypes of distal (lateral) end segment fractures of the clavicle
Advanced Therapies | AT-19-141
![Page 16: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/16.jpg)
16Unrestricted © Siemens Healthineers, 2019
Background therapy
ORIF – Hook plateOpen reduction, temporary fixation with K-wire, plate application and ligament repair
Advanced Therapies | AT-19-141Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
![Page 17: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/17.jpg)
17Unrestricted © Siemens Healthineers, 2019
Patient history
Classification: Lateral fracture of the left clavicle of type 15.3 C1 (AO)
Remarks:• Fell off a horse• Gilchrist-bandage• Hematoma, swelling and pain in AC joint
region• No peripheral motorical or neurological
deficits
Advanced Therapies | AT-19-141
Gender female
Age 46 - 60
![Page 18: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/18.jpg)
18Unrestricted © Siemens Healthineers, 2019
18Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative X-ray imagesAP and tangential view of left clavicle
• Lateral clavicle fracture• Fracture dislocation of more than one shaft width in AP
view
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 19: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/19.jpg)
19Unrestricted © Siemens Healthineers, 2019
19Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingAP view of left clavicle
• Correct anatomic reduction of AC joint• Correct position of the hook plate• No vertical dislocation• Good bony contrast in spite of metal objects• Good field of view
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 20: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/20.jpg)
20Unrestricted © Siemens Healthineers, 2019
20Unrestricted © Siemens Healthineers, 2019
Surgical procedureAxial view
Intraoperative imagingAxial view of left clavicle
• Correct anatomic reduction of AC joint• Correct position of the hook plate• No sagittal dislocation
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 21: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/21.jpg)
21Unrestricted © Siemens Healthineers, 2019
Clinical Case
Femur
Advanced Therapies | AT-19-141
Back tocontent slideclinical cases
![Page 22: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/22.jpg)
22Unrestricted © Siemens Healthineers, 2019
Intraoperative imaging with Cios Select FDClinical case – Femur
• Background pathology
• Background therapy
• Patient history
• Preoperative findings
• Surgical procedure
Anterior viewLateral view
Advanced Therapies | AT-19-141
![Page 23: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/23.jpg)
23Unrestricted © Siemens Healthineers, 2019
Background pathology
AO ClassificationDiaphyseal and distal femur fractures
Advanced Therapies | AT-19-141Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
![Page 24: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/24.jpg)
24Unrestricted © Siemens Healthineers, 2019
Background therapy
ORIF – Compression platingDynamic compression and plate fixation
Advanced Therapies | AT-19-141Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
![Page 25: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/25.jpg)
25Unrestricted © Siemens Healthineers, 2019
Patient history
Classification: Complex multi-segmental dislocated femur fracture
Remarks:• Motorcycle accident, hit by car• Analgosedation, no neurological status• Initial reduction via external fixator
Advanced Therapies | AT-19-141
Gender male
Age 46 - 60
![Page 26: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/26.jpg)
26Unrestricted © Siemens Healthineers, 2019
26Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative X-ray imagesAP view of left upper leg
• Fracture of the left femur with dislocated proximal femoral shaft fracture and comminuted fracture of the distal femur
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 27: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/27.jpg)
27Unrestricted © Siemens Healthineers, 2019
27Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingAP view of left upper leg
• Anatomical reduction via plating• Correct implant position
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 28: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/28.jpg)
28Unrestricted © Siemens Healthineers, 2019
28Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingAP view of left upper leg
• Good bony contrast in spite of metal objects• Good field of view
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 29: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/29.jpg)
29Unrestricted © Siemens Healthineers, 2019
29Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingAP view of left upper leg
• No intra-articular screw penetration• Plate not completely shown
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 30: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/30.jpg)
30Unrestricted © Siemens Healthineers, 2019
30Unrestricted © Siemens Healthineers, 2019
Surgical procedureLateral view
Intraoperative imagingLateral view of left upper leg
• Small dorsal fracture gap of the proximal femur
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 31: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/31.jpg)
31Unrestricted © Siemens Healthineers, 2019
31Unrestricted © Siemens Healthineers, 2019
Surgical procedureLateral view
Intraoperative imagingLateral view of left upper leg
• Correct plate position• No intra-articular screw penetration
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 32: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/32.jpg)
32Unrestricted © Siemens Healthineers, 2019
Clinical Case
Humerus distal
Advanced Therapies | AT-19-141
Back tocontent slideclinical cases
![Page 33: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/33.jpg)
33Unrestricted © Siemens Healthineers, 2019
Intraoperative imaging with Cios Select FDClinical case – Humerus distal
• Background pathology
• Background therapy
• Patient history
• Preoperative findings
• Surgical procedure
Anterior viewLateral view
Advanced Therapies | AT-19-141
![Page 34: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/34.jpg)
34Unrestricted © Siemens Healthineers, 2019
Background pathology
Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
AO ClassificationFractures of the distal humerus
Advanced Therapies | AT-19-141
![Page 35: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/35.jpg)
35Unrestricted © Siemens Healthineers, 2019
Background therapy
ORIF – Screw fixationOpen reduction and K-Wire navigated screw fixation
Advanced Therapies | AT-19-141Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
![Page 36: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/36.jpg)
36Unrestricted © Siemens Healthineers, 2019
Patient history
Classification: Type 13-C3 (AO)
Remarks:• Stumbling fall• Initial immobilization via upper arm plaster cast• Pain and bony crepitation of the left elbow joint• No peripheral motorical or neurological deficits
Advanced Therapies | AT-19-141
Gender female
Age 61 - 75
![Page 37: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/37.jpg)
37Unrestricted © Siemens Healthineers, 2019
37Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative X-ray pictureLeft elbow
1. AP in extension
2. Lateral in flexion
Advanced Therapies | AT-19-141
1. 2.
BG Trauma Center Ludwigshafen, Germany
![Page 38: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/38.jpg)
38Unrestricted © Siemens Healthineers, 2019
38Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative CTLeft elbow
• Plaster cast
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 39: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/39.jpg)
39Unrestricted © Siemens Healthineers, 2019
39Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative CTLeft elbow
• Fracture of the distal humerus with multi-fragmentary trochlea and capitulum fracture
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 40: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/40.jpg)
40Unrestricted © Siemens Healthineers, 2019
40Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingAP view of left elbow
• Anatomical reduction• Fixation of ulnar and radial ligaments via 2 FASTak-
Anchors• Good bony contrast in spite of metal objects
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 41: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/41.jpg)
41Unrestricted © Siemens Healthineers, 2019
41Unrestricted © Siemens Healthineers, 2019
Surgical procedureLateral view
Intraoperative imagingLateral view of left elbow
• Anatomical reduction• No intra-articular screw penetration
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 42: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/42.jpg)
42Unrestricted © Siemens Healthineers, 2019
Clinical Case
Tibia
Advanced Therapies | AT-19-141
Back tocontent slideclinical cases
![Page 43: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/43.jpg)
43Unrestricted © Siemens Healthineers, 2019
Intraoperative imaging with Cios Select FDClinical case – Tibia
• Background pathology
• Background therapy
• Patient history
• Preoperative findings
• Surgical procedure
Anterior viewLateral view
Advanced Therapies | AT-19-141
![Page 44: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/44.jpg)
44Unrestricted © Siemens Healthineers, 2019
Background pathology
Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
AO ClassificationDiaphyseal fractures of the lower leg
Advanced Therapies | AT-19-141
![Page 45: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/45.jpg)
45Unrestricted © Siemens Healthineers, 2019
Background therapy
MIO – Compression platingApproaches and Reduction (plate + interfragmentary lag screw)
Advanced Therapies | AT-19-141Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
![Page 46: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/46.jpg)
46Unrestricted © Siemens Healthineers, 2019
Patient history
Classification: Type 42 A1 (AO)
Remarks:• Skating accident• Closed fracture of right lower leg• Closed reduction by emergency doctor• Pain and deformity of lower leg• No peripheral neurological and motorical deficits
Advanced Therapies | AT-19-141
Gender female
Age 13 - 17
![Page 47: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/47.jpg)
47Unrestricted © Siemens Healthineers, 2019
47Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative X-ray imagesRight lower leg in AP and Lateral view
• Simple spiral fracture of the lower leg• Minimally displaced
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 48: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/48.jpg)
48Unrestricted © Siemens Healthineers, 2019
48Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingAP view of lower leg
• Anatomical reduction• Correct implant position• Good bony contrast in spite of metal objects• Sufficient field of view
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 49: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/49.jpg)
49Unrestricted © Siemens Healthineers, 2019
49Unrestricted © Siemens Healthineers, 2019
Surgical procedureLateral view
Intraoperative imagingLateral view of lower leg
• Anatomical reduction• Correct implant placement• Plates not completely displayed
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 50: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/50.jpg)
50Unrestricted © Siemens Healthineers, 2019
Clinical Case
Tibia plateau
Advanced Therapies | AT-19-141
Back tocontent slideclinical cases
![Page 51: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/51.jpg)
51Unrestricted © Siemens Healthineers, 2019
Intraoperative imaging with Cios Select FDClinical case – Tibia plateau
• Background pathology
• Background therapy
• Patient history
• Preoperative findings
• Surgical procedure
Anterior viewLateral view
Advanced Therapies | AT-19-141
![Page 52: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/52.jpg)
52Unrestricted © Siemens Healthineers, 2019
Background pathology
Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
AO ClassificationTibia plateau fractures
Advanced Therapies | AT-19-141
![Page 53: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/53.jpg)
53Unrestricted © Siemens Healthineers, 2019
Background therapy
Copyright by AO Foundation, Switzerland Source: AO Surgery Reference, www.aosurgery.org
ORIF – Plates with angular stabilityReduction of articular surface, filling of defect or adjustment osteotomy, plate fixation
Advanced Therapies | AT-19-141
![Page 54: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/54.jpg)
54Unrestricted © Siemens Healthineers, 2019
Patient history
Classification: Lateral fracture of the left tibia plateau type 41-B3 (AO)
Remarks:• Direct impact trauma of the left knee during handball• Persistent pain symptoms and joint effusion despite
relief by forearm crutches• MR diagnostics• Pressure pain in lateral joint segment and restricted
range of motion (Ex/Flex 0-20-50°)• No peripheral motorical and neurological deficits
Advanced Therapies | AT-19-141
Gender female
Age 18 - 30
![Page 55: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/55.jpg)
55Unrestricted © Siemens Healthineers, 2019
55Unrestricted © Siemens Healthineers, 2019
Preoperative findings
Preoperative CTAxial and coronal view of left knee joint
• Ventrolateral impression fracture of the tibia plateau with lateral articular depression of 8 mm
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 56: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/56.jpg)
56Unrestricted © Siemens Healthineers, 2019
56Unrestricted © Siemens Healthineers, 2019
Surgical procedure AP view
Intraoperative imagingAP view of left knee joint
• Anatomical reduction of tibia plateau alignment• No fragment dislocation after adjustment osteotomy• Correct plate position• No intra-articular screw penetration• Good bony contrast in spite of metal objects
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 57: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/57.jpg)
57Unrestricted © Siemens Healthineers, 2019
57Unrestricted © Siemens Healthineers, 2019
Surgical procedureLateral view
Intraoperative imagingLateral view of left knee joint
• Correct plate position• No sagittal fragment dislocation• No intra-articular fragments or screw penetration
Advanced Therapies | AT-19-141BG Trauma Center Ludwigshafen, Germany
![Page 58: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/58.jpg)
58Unrestricted © Siemens Healthineers, 2019
Cios Select FD
Conclusion
Advanced Therapies | AT-19-141
Back tocontent slideclinical cases
![Page 59: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/59.jpg)
59Unrestricted © Siemens Healthineers, 2019
„In my opinion, Cios Select FD can be used for everyprocedure in orthopedic trauma. This C-arm is easy to handle and with a few minutes of introductionthe improved user interface can be operated byeveryone. But most important for me: Cios Select FD provides a new level of two-dimensional intraoperative imaging in terms of image quality!“
Dr. med. Jochen Franke,Head – Division of TraumaDepartment for Orthopedic and Trauma Surgery BG Trauma Center Ludwigshafen at Heidelberg University Hospital Germany
The statements by Siemens’ customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.
Advanced Therapies | AT-19-141
![Page 60: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/60.jpg)
60Unrestricted © Siemens Healthineers, 2019
Cios Select FDSelect smart surgical imaging
* Option
Easy patient and system positioning thanks to large C-arm geometry
Wireless footswitch*
for cableless freedom in the OR
Display of live and reference images in high detail thanks to high bright color monitors
Advanced connectivity thanks to wireless DICOM*
Flexible and consistent system control viasmart touch user interface
See more anatomical details with Retina FD technology
The right dose in each individual case thanks to CARE technology
Smart power management for the right power whereverand whenever you need it
Advanced Therapies | AT-19-141
![Page 61: Intraoperative Imaging with Cios Select FD](https://reader034.vdocuments.net/reader034/viewer/2022042922/626ac3dcc7ceec553851ef7f/html5/thumbnails/61.jpg)
61Unrestricted © Siemens Healthineers, 2019
Thank you for your enthusiasm!
Siemens Healthineers HeadquartersSiemens Healthcare GmbHHenkestr. 12791052 ErlangenGermanyPhone: +49 9131 84-0siemens-healthineers.com
Advanced Therapies | AT-19-141
On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this presentation are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and are subject to change without prior notice.
The customers cited are employed by an institution that might provide Siemens product reference services, R&D collaboration or other relationship for compensation pursuant to a written agreement.