Three-Dimensional Imaging of Displaced Intra-articular Calcaneal Fractures Correlates With the Perioperative Diagnosis.
3-D reconstruction imaging
calcaneal fracture
Journal
Foot & ankle orthopaedics
ISSN: 2473-0114
Titre abrégé: Foot Ankle Orthop
Pays: United States
ID NLM: 101752333
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
entrez:
31
1
2022
pubmed:
1
2
2022
medline:
1
2
2022
Statut:
epublish
Résumé
Intra-articular calcaneal fractures are complex injuries, and CT imaging has become the standard imaging in the preoperative assessment. Most classifications of these fractures are CT-based but have been associated with limited interobserver agreement. Three-dimensional imaging has become widely available and may give a better perspective but often with 1 image only. There is not much evidence of the added value of this imaging, compared with the CT imaging. Eight experienced trauma surgeons assessed 28 different intra-articular calcaneal fractures, on conventional radiology (CR), CT, and 3-D imaging. All had extensive experience in the diagnosis and treatment of this difficult injury. The main questions concerned Sanders classification, the severity of the injury and the difficulty of the operative procedure, choice of approach, and choice of procedure. The classical 2-D CT imaging of the fractures were associated with a higher Sanders classification ranking, compared with the 3-D imaging scores. However, the interobserver agreement, as measured by the Fleiss kappa, was low for all 3 imaging modalities. We found more frequent Sanders III and IV classifications with CT scan imaging compared with 3-D imaging or CR. The scores obtained after assessing 3-D imaging were also not statistically significantly different from the scores of a consensus achieved by 2 authors and based on the 3 imaging modalities and the perioperative diagnosis. The 3-D imaging may result in a more realistic view, reducing the frequency of classifying Sanders III fractures than with the 2-D CT imaging series. 3-D imaging may be more reliable than CT in the planning of operative treatment of displaced intra-articular calcaneal fractures. Level III.
Sections du résumé
BACKGROUND
BACKGROUND
Intra-articular calcaneal fractures are complex injuries, and CT imaging has become the standard imaging in the preoperative assessment. Most classifications of these fractures are CT-based but have been associated with limited interobserver agreement. Three-dimensional imaging has become widely available and may give a better perspective but often with 1 image only. There is not much evidence of the added value of this imaging, compared with the CT imaging.
METHODS
METHODS
Eight experienced trauma surgeons assessed 28 different intra-articular calcaneal fractures, on conventional radiology (CR), CT, and 3-D imaging. All had extensive experience in the diagnosis and treatment of this difficult injury. The main questions concerned Sanders classification, the severity of the injury and the difficulty of the operative procedure, choice of approach, and choice of procedure.
RESULTS
RESULTS
The classical 2-D CT imaging of the fractures were associated with a higher Sanders classification ranking, compared with the 3-D imaging scores. However, the interobserver agreement, as measured by the Fleiss kappa, was low for all 3 imaging modalities. We found more frequent Sanders III and IV classifications with CT scan imaging compared with 3-D imaging or CR. The scores obtained after assessing 3-D imaging were also not statistically significantly different from the scores of a consensus achieved by 2 authors and based on the 3 imaging modalities and the perioperative diagnosis.
CONCLUSION
CONCLUSIONS
The 3-D imaging may result in a more realistic view, reducing the frequency of classifying Sanders III fractures than with the 2-D CT imaging series. 3-D imaging may be more reliable than CT in the planning of operative treatment of displaced intra-articular calcaneal fractures.
LEVEL OF EVIDENCE
METHODS
Level III.
Identifiants
pubmed: 35097457
doi: 10.1177/24730114211019729
pii: 10.1177_24730114211019729
pmc: PMC8564932
doi:
Types de publication
Journal Article
Langues
eng
Pagination
24730114211019729Informations de copyright
© The Author(s) 2021.
Déclaration de conflit d'intérêts
Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.
Références
Injury. 2014 Jul;45(7):1117-20
pubmed: 24530220
J Surg Educ. 2020 Mar - Apr;77(2):472-478
pubmed: 32033916
Foot Ankle Surg. 2022 Jan;28(1):88-92
pubmed: 33563519
Foot Ankle Int. 2012 Sep;33(9):727-33
pubmed: 22995259
J Foot Ankle Surg. 2018 May - Jun;57(3):440-444
pubmed: 29398511
Foot Ankle Int. 2016 Nov;37(11):1211-1217
pubmed: 27530985
Arch Orthop Trauma Surg. 2011 Oct;131(10):1397-403
pubmed: 21544641
J Foot Ankle Surg. 2009 Mar-Apr;48(2):156-62
pubmed: 19232967
Foot (Edinb). 2020 Jun;43:101659
pubmed: 32087446
Foot Ankle Surg. 2020 Jan;26(1):94-97
pubmed: 30587438
J Chiropr Med. 2016 Jun;15(2):155-63
pubmed: 27330520
J Bone Joint Surg Am. 2008 May;90(5):1013-21
pubmed: 18451393
Foot Ankle. 1991 Apr;11(5):254-63
pubmed: 2037267
Orthop Clin North Am. 1995 Apr;26(2):203-14
pubmed: 7724187
J Orthop Trauma. 2005 Oct;19(9):616-22
pubmed: 16247306
J Invest Surg. 2018 Dec;31(6):557-567
pubmed: 28925760