Diagnostic accuracy of digital imaging and computed tomography in calcaneal fracture evaluation
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20252639Keywords:
Computed tomography, Calcaneal fractures, Digital X-rayAbstract
Background: Initially, suspected calcaneal fractures are typically evaluated using conventional radiography. However, contemporary classification systems for calcaneal fractures rely heavily on computed tomography (CT) due to its ability to provide three-dimensional imaging, which offers a more comprehensive assessment than traditional two-dimensional plain radiography. This study aimed to investigate and compare the diagnostic efficacy of digital X-ray imaging versus computed tomography in evaluating calcaneal fractures.
Methods: This study was conducted S.M.S Medical College Jaipur on 40 patients with isolated calcaneal trauma and was diagnosed radiologically by plain X-ray and CT to have calcaneal fractures. lateral view images was obtained to measure the Böhler’s angle, the angle of Gissane, the inclination angle and the facet height. Each angle was measured by two different interpreters (a senior radiologist and a resident) in order to verify accuracy.
Results: A statistically significant difference was observed between Digital X-ray and CT image findings in both intra-articular fractures and total fractures. Specifically, significant differences were noted in the measurements of Bohler's angle, the angle of Gissane and facet height, whereas no significant difference was found in the inclination angle. These findings highlight the superior diagnostic accuracy of CT imaging in assessing calcaneal fractures.
Conclusions: Computed Tomography (CT) scanning has emerged as a indispensable, non-invasive diagnostic tool, widely adopted for its exceptional utility in accurately identifying, classifying and informing treatment strategies for both extra-articular and intra-articular calcaneal fractures, thereby revolutionizing the management of these complex injuries.
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References
Ratliff AH, Dixon JH, Magnussen PA, Young SK. Selected References in Orthopaedic Trauma. Springer Science Business Media. 2012.
McReynolds IS. Trauma to the os calcis and heel cord. Disorders Foot Ankle. 1982;2:1497-542.
Sanders R. Current concepts review-displaced intra-articular fractures of the calcaneus. JBJS. 2000;82(2):225-50. DOI: https://doi.org/10.2106/00004623-200002000-00009
Heckman J. Fractures and dislocations of the Foot, chapter 32. Rockwood Green’s Fract Adults. 1996;2:2325-54.
Janzen DL, Connell DG, Munk PL, Buckley RE, Meek RN, Schechter MT. Intraarticular fractures of the calcaneus: value of CT findings in determin- ing prognosis. AJR Am J Roentgenol. 1992;158(6):1271–4.
Schechter MT. Intraarticular fractures of the calcaneus: value of CT findings in determining prognosis. AJR Am J Roentgenol. 1992;158(6):1271–4. DOI: https://doi.org/10.2214/ajr.158.6.1590122
Rubino R, Valderrabano V, Sutter PM, Regazzoni P. Prognostic value of four classifications of calcaneal fractures. Foot Ankle Int. 2009;30(3):229–3. DOI: https://doi.org/10.3113/FAI.2009.0229
Koval K, Sanders R. the radiologic evaluation of calcaneal fractures. Clin Orthop. 1993;290:41-58. DOI: https://doi.org/10.1097/00003086-199305000-00006
Makki D, Alnajjar HM, Walkay S. Osteosynthesis of displaced intra- articular. J Bone Joint Surg. 2010;92:693-700. DOI: https://doi.org/10.1302/0301-620X.92B5.23542
Parmer HV, Triffitt PD, Gregg PJ. Intra–articular fractures of calcaneus treated operatively or conservatively: a prospective study. J Bone Joint Surg. 1993;75:932-43. DOI: https://doi.org/10.1302/0301-620X.75B6.8245085
Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D, et al. Operative compared with non-operative treatment of dispalced intra-articular calcaneal fractures: a prospective, randomised, controlled multicentric trial. JBJS. 2002;84:1733-44. DOI: https://doi.org/10.2106/00004623-200210000-00001
Nambiar MR, Umesh SN, Kamath KR. Percutaneous pin fixation of calcaneal fractures. J Orthop Assoc South India. 2004;1:64-7.
Paley D, Fischgrund J. Open reduction and circular external fixation of intra–articular calcaneal fractures. Clin Orthop. 1993;290:125–40. DOI: https://doi.org/10.1097/00003086-199305000-00016
Stoller DW, Tirman PF, Bredella M. Ankle and foot, osseous fractures, calcaneal fractures. Diagnostic imaging: orthopaedics. Salt Lake City, Utah: Amirsys. 2004;40:70-4.
Berberian W, Sood A, Karanfilian B, Najarian R, Lin S, Liporace F. CT classification and results of operative treatment. Foot Ankle Clin. 2013;55(211):43-51.
Biz C, Barison E, Ruggieri P, Iacobellis C. Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: a comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS). J Orthop Surg Res. 2016;11(1):92. DOI: https://doi.org/10.1186/s13018-016-0426-6
Veltman ES, van den Bekerom MP, Doornberg JN. Three-dimensional computed tomography is not indicated for the classification and characterization of calcaneal fractures. Injury. 2014;45(7):1117-20. DOI: https://doi.org/10.1016/j.injury.2014.01.022
Choplin RH, Farber JM, Buckwalter KA, Swan S. Three- dimensional volume rendering of the tendons of the ankle and foot. Semin Musculoskelet Radiol. 2004;8(2):175-83. DOI: https://doi.org/10.1055/s-2004-829489
Pretorius ES, Fishman EK. Volume-rendered three-dimen- sional spiral CT: musculoskeletal applications. Radiographics. 1999;19(5):1143-60. DOI: https://doi.org/10.1148/radiographics.19.5.g99se061143
Cotten AIS, Moise AB. Musculoskeletal System. Berlin, Heidelberg: Springer; 2002.
Allon SM, Mears DC. Three dimensional analysis of calca- neal fractures. Foot Ankle. 1991;11(5):254-63. DOI: https://doi.org/10.1177/107110079101100502
Pate D, Resnick D, Andre M, Sartoris DJ. Perspective: three-dimensional imaging of the musculoskeletal system. AJR Am J Röntgenol. 1986;147(3):545-51. DOI: https://doi.org/10.2214/ajr.147.3.545
Prasartritha T, Sethavanitch C. Three-dimensional and two- dimensional computerized tomographic demonstration of cal- caneus fractures. Foot Ankle Int. 2004;25(4):262-73. DOI: https://doi.org/10.1177/107110070402500412
Griffin D, Parsons N, Shaw E, Kulikov Y, Hutchinson C, Thorogood M, et al. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial. BMJ. 2014;349:6779. DOI: https://doi.org/10.1136/bmj.g4483
Daftary A, Haims AH, Baumgaertner MR. Fractures of the calcaneus: a review with emphasis on CT. Radiographics. 2005;25(5):1215-26. DOI: https://doi.org/10.1148/rg.255045713
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