Dr. Korsh Jafarnia

The upper extremity value of mini C-arms in the ER and OR

April 23, 2019
By Dr. Korsh Jafarnia

In modern healthcare practice, a clinician’s capabilities are more closely linked to their tools than ever before. The medical technology available today enables clinicians to effectively handle a wide variety of cases and situations, improving both professional performance and patient experience. When it comes to the orthopedic field specifically, surgical suites have conventionally relied upon C-arms during extremity procedures. More recently, the integration of mini C-arm technology has improved efficiency and patient outcomes, providing orthopedic surgeons with greater maneuverability as well as high quality imaging and streamlined features. During my years as a hand and upper extremity surgeon, I’ve dealt with a wide variety of cases and have used a number of different pieces of orthopedic equipment. Whether in the OR or the ER, mini C-arms have become essential to my performance as a clinician, allowing me to be more efficient and effective.

C-arm systems are a staple of any and all orthopedic practices, designed for cases requiring increased flexibility. During procedures, this technology provides essential fluoroscopic intraoperative imaging, enabling clinicians to track progress and immediately make any necessary adjustments. While newer mini C-arm technology can help streamline procedures, older or larger C-arms can actually stymie operations and be burdensome to both clinicians and patients. These larger systems can be constrained by a restricted range of motion and arc, requiring clinicians to constantly readjust and realign patients. Additionally, older C-arms often have a reduced field of view, forcing clinicians to take numerous X-rays before they can construct a complete visual. With modern mini C-arm systems, I find the opposite – they boast increased maneuverability and high-resolution imagery that benefit clinicians and patients alike. More agile systems such as Hologic’s Fluoroscan InSight Mini C-arm deliver higher quality images, a larger field of view, and a modern ergonomic design that allows for greater accuracy and efficiency. The compact size and range of flexibility means I can spend less time maneuvering the system and patient, enabling me to quickly capture the angles and images I need and make any subsequent course corrections in real time.

As a hand and upper extremity specialist, the accuracy, ease and speed of this technology benefits my performance across a variety of patient cases. For example, maneuvering around the hand, wrist and elbow is extremely difficult, especially when done with a larger inflexible imaging system. Mini C-arm systems, on the other hand, typically have multiple arms that allow me to easily contour around an extremity and get the exact alignment necessary, which is especially useful for performing fracture fixation in a timely manner. Additionally, certain mini C-arm systems feature a rotating flat detector, enabling me to capture a longitudinal X-ray of the arm rather than having to take numerous images while moving the system up and down the arm. The benefits also translate to the patient as well. Special beds or arm boards are not needed, as patients can be imaged on a standard OR bed by simply lifting the system up and telescoping around the extremity.

Interestingly enough, I’ve found mini C-arm systems to be equally useful and applicable to both the operating room and emergency room. The OR is a confined space in which workflow and efficiency are key. While bigger, more intrusive C-arms can take up valuable real estate, impeding the staff and confining the patient, mini C-arms give way to a more streamlined operating environment. For intricate hand and upper extremity cases, maneuverability and accuracy are crucial. As for the ER, mini C-arms allow me to promptly address a patient’s needs, especially for cases like small fractures. For example, if a patient comes in with a wrist fracture, I can use the mini C-arm to perform a reduction right there in the emergency room, rather than having to send them to the radiology department and await results before getting to work. Across a wide variety of situations, mini C-arm systems improve efficiency and results, while also allowing me to use less radiation.

Whether in the OR or the ER, today’s mini C-arm systems provide high-quality imaging and a superior range of motion, benefiting clinician accuracy and patient outcomes. As an orthopedic surgeon, I’m focused on being as effective and efficient as I can, and I never want to be second guessing the images I’m capturing while my patient is under anesthesia. Using modern mini C-arm technology, I can trust the alignment and images I see during procedures and do my job with precision and certainty. I encourage other surgeons to embrace new technologies like mini C-arms – not only am I more efficient in my procedures, but more importantly, I’m delivering the highest-quality of care to my patients.

About the author: Korsh Jafarnia, MD, is a board-certified, fellowship trained orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine. Additionally, he is an Assistant Professor of Clinical Orthopedic Surgery at the Weill Cornell Medical College as well as at the Houston Methodist Institute for Academic Medicine.