Christina Roll1, Johanna Schirmbeck1, Franz Müller2, Carsten Neumann1, Bernd Kinner3. 1. Department of Trauma and Reconstructive Surgery, University of Regensburg, Regensburg, Germany. 2. Department of Trauma and Reconstructive Surgery, Hospital Barmherzige Brüder Regensburg, Regensburg, Germany. 3. Department of Orthopaedic and Trauma Surgery, Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Germany bernd.kinner@rbk.de.
Abstract
BACKGROUND: The interpretation of CT scans for the evaluation of calcaneal fractures is difficult. Three-dimensional (3D) reconstruction (volume rendering technique [VRT]) has been valuable in the evaluation of irregularly shaped bones. However, their value for the analysis of calcaneal fractures is still debated. Therefore, the objective of this study was to assess the effect of additional use of 3D CTs in calcaneal fractures. METHODS: In a prospective multicenter study, the CT data set of 5 different fractures was presented to 57 evaluators. First, the participating surgeons were asked to assess the fractures on the basis of axial, coronal, and sagittal reconstructions using a multiple-choice questionnaire. Second, 3D reconstructions (VRT) were presented. The CT scans were validated by the intraoperative findings and the results were compared to the model solution of 3 foot and ankle surgeons. Intra- and interrater reliabilities were calculated. RESULTS: The proportion of intraobserver agreement was 82%, with Cohen kappa of κ = 0.748 (P < .001). Interrater agreement varied between 0.772 (P = .006) for the assessment of concomitant fractures and 0.987 (P < .001) for the suggested approach. The evaluation of several items improved after presentation of the 3D CTs (Cochrane Q test, P < .001). The benefit of 3D imaging was higher in inexperienced surgeons and complex fractures (Friedman test P < .001). CONCLUSION: The evaluation of CT scans of calcaneal fractures was improved by the additional use of 3D images (VRT). LEVEL OF EVIDENCE: Level II, prospective comparative study.
BACKGROUND: The interpretation of CT scans for the evaluation of calcaneal fractures is difficult. Three-dimensional (3D) reconstruction (volume rendering technique [VRT]) has been valuable in the evaluation of irregularly shaped bones. However, their value for the analysis of calcaneal fractures is still debated. Therefore, the objective of this study was to assess the effect of additional use of 3D CTs in calcaneal fractures. METHODS: In a prospective multicenter study, the CT data set of 5 different fractures was presented to 57 evaluators. First, the participating surgeons were asked to assess the fractures on the basis of axial, coronal, and sagittal reconstructions using a multiple-choice questionnaire. Second, 3D reconstructions (VRT) were presented. The CT scans were validated by the intraoperative findings and the results were compared to the model solution of 3 foot and ankle surgeons. Intra- and interrater reliabilities were calculated. RESULTS: The proportion of intraobserver agreement was 82%, with Cohen kappa of κ = 0.748 (P < .001). Interrater agreement varied between 0.772 (P = .006) for the assessment of concomitant fractures and 0.987 (P < .001) for the suggested approach. The evaluation of several items improved after presentation of the 3D CTs (Cochrane Q test, P < .001). The benefit of 3D imaging was higher in inexperienced surgeons and complex fractures (Friedman test P < .001). CONCLUSION: The evaluation of CT scans of calcaneal fractures was improved by the additional use of 3D images (VRT). LEVEL OF EVIDENCE: Level II, prospective comparative study.
Authors: Antoine Fourgeaux; John Estens; Thierry Fabre; Olivier Laffenetre; Julien Lucas Y Hernandez Journal: Int Orthop Date: 2019-08-01 Impact factor: 3.075
Authors: Dominique Misselyn; Tim Schepers; Richard Buckley; Michael Swords; Giovanni Matricali; Stefaan Nijs Journal: Foot Ankle Orthop Date: 2021-07-06