22.1.1 Vertebral column - 290
22.1.2 Pelvis/acetabulum - 294
22.1.3 Elbow/wrist - 296
22.1.4 Hips/DHS/neck of the femur: screwed solutions - 298
22.1.5 Head of the tibia and lower leg - 300
22.1.6 Ankle/pilon/talus - 302
22.1.7 Calcaneus fractures - 304
22.1 Iso-C3D applications with and without navigation
Basic ISC-C3D applications. During operations to the extremities, the extremity not being operated does not disturb much in the ray path, only the cube in the Iso centre (12x12x12 cm) is calculated and displayed.
A carbon operating table should always be used whenever possible. If an operating table contains metal bracing, the region being scanned must be positioned centrally on the table, or in the case of the hand or feet, the extremity can be allowed to hang over the edge of the table.
The Iso C-arm is covered with special sterile foil. In addition, the operation site should also be covered with sterile sheets. One useful method consists of wrapping the extremity in a stockinette. It is also advisable to wrap the table in a sterile sheet so that the device can rotate around the table.
In the case of the VIWAS table (single-section carbon operating table top), care must be taken to ensure that the duplex columns are as far as possible from the position of the C-arm.
Losses in quality can be caused above all when the region being examined is not positioned exactly in the central ray path. Such a central position should be correctly adjusted and verified in both levels before starting the scan. Bumping into the C-arm during the automatic orbital movement always means that the scan has to be aborted.
Navigation. The specific set-up must be known already before beginning the operation, and started before the operation or parallel to positioning the patient. Particular attention should be given to the position of the camera.
The units/camera positions described here are rated specifically for systems with autonomous camera as autonomous unit (e.g. Optotrack/Medi-vision).
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