Y Chen1, K Zhang2, M Qiang2, H Li2, H Dai2. 1. Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, 200120 Shanghai, China. Electronic address: cyxtongji@126.com. 2. Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, 200120 Shanghai, China.
Abstract
AIM: To compare postoperative plain radiographs with computed tomography (CT) post-processing images in evaluating the quality of anatomical reduction and internal fixation of ankle fractures. MATERIALS AND METHODS: A total of 168 patients who sustained closed ankle fracture and were treated with open reduction and internal fixation in East Hospital were reviewed. Postoperative plain radiographs and CT post-processing images were evaluated. The observation was performed under volume-rendering mode and multiplanar reconstruction mode. The assessment was performed by two independent orthopaedic surgeons. The inter- and intra-observer variations were analysed by kappa statistics. The differences between plain radiographs and CT post-processing images were compared using χ(2) test (McNemar's test). RESULTS: Inter- and intra-observer agreement was almost perfect (0.813-1.000) using CT post-processing images, which was higher than that using plain radiographs (0.323-0.848). More non-anatomical reduction could be recognised in the supination-external rotation (SER), supination-adduction (SAD), pronation-external rotation (PER), and overall groups (p<0.05) and more poor internal fixation could be recognised in the SER, SAD, and overall groups (p<0.05) using CT post-processing images than using radiographs. CONCLUSION: More residual articular step, fracture fragment displacement, and poor internal fixation could be detected by CT post-processing images than plain radiographs.
AIM: To compare postoperative plain radiographs with computed tomography (CT) post-processing images in evaluating the quality of anatomical reduction and internal fixation of ankle fractures. MATERIALS AND METHODS: A total of 168 patients who sustained closed ankle fracture and were treated with open reduction and internal fixation in East Hospital were reviewed. Postoperative plain radiographs and CT post-processing images were evaluated. The observation was performed under volume-rendering mode and multiplanar reconstruction mode. The assessment was performed by two independent orthopaedic surgeons. The inter- and intra-observer variations were analysed by kappa statistics. The differences between plain radiographs and CT post-processing images were compared using χ(2) test (McNemar's test). RESULTS: Inter- and intra-observer agreement was almost perfect (0.813-1.000) using CT post-processing images, which was higher than that using plain radiographs (0.323-0.848). More non-anatomical reduction could be recognised in the supination-external rotation (SER), supination-adduction (SAD), pronation-external rotation (PER), and overall groups (p<0.05) and more poor internal fixation could be recognised in the SER, SAD, and overall groups (p<0.05) using CT post-processing images than using radiographs. CONCLUSION: More residual articular step, fracture fragment displacement, and poor internal fixation could be detected by CT post-processing images than plain radiographs.
Authors: Nils Beisemann; Antonella M Tilk; Jula Gierse; Paul A Grützner; Jochen Franke; Jeffrey H Siewerdsen; Sven Y Vetter Journal: BMC Med Imaging Date: 2022-10-19 Impact factor: 2.795