The utility of air on computed tomography scans in the assessment of type 1 open fractures.
Air
CT
Diagnostic
Subfascial
Type one open fracture
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
20
03
2022
accepted:
11
05
2022
medline:
26
4
2023
pubmed:
24
5
2022
entrez:
23
5
2022
Statut:
ppublish
Résumé
The presence of air on computed tomography (CT) scans has been demonstrated to accurately diagnose occult traumatic arthrotomies. The purpose of this study was to determine if the presence of air on CT scans also has diagnostic utility for type 1 open fractures. A retrospective review at a level 1 trauma center identified twenty-eight patients with Gustilo-Anderson Type 1 open fractures and preoperative CT scans. These patients were matched 2:1 with 56 closed fractures who also had CT scans. CT scans were reviewed to determine the presence of suprafascial and subfascial air. Air near the fracture site on CT scan was more common in open fractures then closed fractures (21 (75%) vs. 9 (16%) patients, proportional difference: 59% (37-75%), p < 0.0001). In the open fracture group, 18 (64.2%) patients had both supra- and subfascial air, 2 (7.1%) patients had isolated subfascial air, and 1 (3.5%) patient had isolated suprafascial air. In the closed fracture group, 3 (5.3%) patients had supra- and subfascial air, 4 (7.1%) had isolated subfascial air, and 2 (3.5%) had isolated suprafascial air. The sensitivity and specificity of air on CT for identifying a type 1 open fracture was 75 and 84%, respectively. This study found that the presence of air on CT scan was more likely in type 1 open versus closed fractures; however, the sensitivity or specificity was too low to be used reliably to identify occult open fractures in isolation. Diagnostic Level III.
Identifiants
pubmed: 35604477
doi: 10.1007/s00590-022-03296-x
pii: 10.1007/s00590-022-03296-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1263-1266Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
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