Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle Fractures
Purpose To review preoperative radiography and computed tomography (CT) of the ankle in 69 patients who underwent surgery for ankle fractures to determine the value of CT in diagnosis and surgical planning. Methods Preoperative radiography and CT of the ankle of 46 women and 23 men aged 17 to 90 (me...
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doaj-d3332a98d4fd440bb1490ed4c3da8b952020-11-25T03:16:58ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902016-08-012410.1177/1602400207Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle FracturesKa Hei Leung0Christian Xin Shuo Fang1Tak Wing Lau2Frankie Ka Li Leung3 Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, ChinaPurpose To review preoperative radiography and computed tomography (CT) of the ankle in 69 patients who underwent surgery for ankle fractures to determine the value of CT in diagnosis and surgical planning. Methods Preoperative radiography and CT of the ankle of 46 women and 23 men aged 17 to 90 (mean, 48.8) years were reviewed. CT was deemed necessary when radiographs showed the following features: (1) comminuted fracture of the medial malleolus involving the tibial plafond, (2) comminuted fracture of the posterior malleolus, (3) presence of loose bodies, and/or (4) suspected Chaput or Volkman fracture fragment. Two orthopaedic surgeons independently reviewed the radiographs to look for any of the above features for which CT was indicated. In patients whose radiographs did not show any of the above features, each surgeon formulated a surgical plan based on radiographs alone and decided if any modification was needed after reviewing the CT scan. Results Based on radiographs of the 69 patients, 19 (28%) patients had features of posterior malleolar comminution (n=7), medial malleolar comminution (n=7), suspected Chaput fracture fragment (n=1), suspected Volkman fracture fragment (n=1), and combination of 2 lesions (n=3), and were deemed to require CT. In 10 (20%) of the remaining 50 patients, the surgical plan was modified after review of the CT scan. The intra- and inter-observer agreement was good to excellent. Conclusion Radiography alone is not adequate for surgical planning for ankle fractures. More accurate imaging tools such as CT are needed to enable a more accurate diagnosis and surgical planning.https://doi.org/10.1177/1602400207 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ka Hei Leung Christian Xin Shuo Fang Tak Wing Lau Frankie Ka Li Leung |
spellingShingle |
Ka Hei Leung Christian Xin Shuo Fang Tak Wing Lau Frankie Ka Li Leung Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle Fractures Journal of Orthopaedic Surgery |
author_facet |
Ka Hei Leung Christian Xin Shuo Fang Tak Wing Lau Frankie Ka Li Leung |
author_sort |
Ka Hei Leung |
title |
Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle Fractures |
title_short |
Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle Fractures |
title_full |
Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle Fractures |
title_fullStr |
Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle Fractures |
title_full_unstemmed |
Preoperative Radiography versus Computed Tomography for Surgical Planning for Ankle Fractures |
title_sort |
preoperative radiography versus computed tomography for surgical planning for ankle fractures |
publisher |
SAGE Publishing |
series |
Journal of Orthopaedic Surgery |
issn |
2309-4990 |
publishDate |
2016-08-01 |
description |
Purpose To review preoperative radiography and computed tomography (CT) of the ankle in 69 patients who underwent surgery for ankle fractures to determine the value of CT in diagnosis and surgical planning. Methods Preoperative radiography and CT of the ankle of 46 women and 23 men aged 17 to 90 (mean, 48.8) years were reviewed. CT was deemed necessary when radiographs showed the following features: (1) comminuted fracture of the medial malleolus involving the tibial plafond, (2) comminuted fracture of the posterior malleolus, (3) presence of loose bodies, and/or (4) suspected Chaput or Volkman fracture fragment. Two orthopaedic surgeons independently reviewed the radiographs to look for any of the above features for which CT was indicated. In patients whose radiographs did not show any of the above features, each surgeon formulated a surgical plan based on radiographs alone and decided if any modification was needed after reviewing the CT scan. Results Based on radiographs of the 69 patients, 19 (28%) patients had features of posterior malleolar comminution (n=7), medial malleolar comminution (n=7), suspected Chaput fracture fragment (n=1), suspected Volkman fracture fragment (n=1), and combination of 2 lesions (n=3), and were deemed to require CT. In 10 (20%) of the remaining 50 patients, the surgical plan was modified after review of the CT scan. The intra- and inter-observer agreement was good to excellent. Conclusion Radiography alone is not adequate for surgical planning for ankle fractures. More accurate imaging tools such as CT are needed to enable a more accurate diagnosis and surgical planning. |
url |
https://doi.org/10.1177/1602400207 |
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