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급성 족근과 골절 환자에서 시행한 컴퓨터 단층촬영 영상의 유용성

Usefulness of Computed Tomography in Patients with Acute Malleolar Fracture

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Purpose: We compared plain radiographs with computed tomography (CT) images to evaluate the usefulness of preoperative CT in acute ankle malleolar fracture in terms of accuracy of diagnosis and planning of operative strategy. Materials and Methods: A retrospective analysis was conducted on 210 cases of malleolar fracture treated at our institute for which plain radiograph and CT were obtained preoperatively. Observers had reviewed plain radiographs and recorded fracture classification, anatomical diagnosis, extent and configuration of fractures and then subsequently reviewed CT images. Records from each image were compared and information regarding the differences in fractures was assessed. Results: Fractures were notably changed in appearance in 88 cases (41.9%) and diagnosis changed in 30 cases (14.3%). According to the change of diagnosis and fracture appearances, the operative strategy was changed in 15 cases (7.1%) including incision, order of reduction, and target of fixation. Conclusion: CT could be a useful adjunctive imaging tool in addition to the plain radiograph in planning of operative treatment for acute malleolar fracture in terms of estimating exact configuration, extent of fractures and even newly revealed hidden fractures

Abstract

Purpose: We compared plain radiographs with computed tomography (CT) images to evaluate the usefulness of preoperative CT in acute ankle malleolar fracture in terms of accuracy of diagnosis and planning of operative strategy. Materials and Methods: A retrospective analysis was conducted on 210 cases of malleolar fracture treated at our institute for which plain radiograph and CT were obtained preoperatively. Observers had reviewed plain radiographs and recorded fracture classification, anatomical diagnosis, extent and configuration of fractures and then subsequently reviewed CT images. Records from each image were compared and information regarding the differences in fractures was assessed. Results: Fractures were notably changed in appearance in 88 cases (41.9%) and diagnosis changed in 30 cases (14.3%). According to the change of diagnosis and fracture appearances, the operative strategy was changed in 15 cases (7.1%) including incision, order of reduction, and target of fixation. Conclusion: CT could be a useful adjunctive imaging tool in addition to the plain radiograph in planning of operative treatment for acute malleolar fracture in terms of estimating exact configuration, extent of fractures and even newly revealed hidden fractures

참고문헌 (7)

  1. Irwin TA, "Posterior malleolus fracture", J Am Acad Orthop Surg, 21, pp.32~40 (2013)
  2. Phisitkul P, "Forceps reduction of the syndesmosis in rotational ankle fractures : a cadaveric study", J Bone Joint Surg Am, 94, pp.2256~2261 (2012)
  3. Magid D, "Adult ankle fractures : comparison of plain films and interactive two-and threedimensional CT scans", AJR Am J Roentgenol, 154, pp.1017~1023 (1990)
  4. Büchler L, "Reliability of radiologic assessment of the fracture anatomy at the posterior tibial plafond in malleolar fractures", J Orthop Trauma, 23, pp.208~212 (2009)
  5. Ferries JS, "Plain radiographic interpretation in trimalleolar ankle fractures poorly assesses posterior fragment size", J Orthop Trauma, 8, pp.328~331 (1994)
  6. Haraguchi N, "Pathoanatomy of posterior malleolar fractures of the ankle", J Bone Joint Surg Am, 88, pp.1085~1092 (2006)
  7. Black EM, "Role of preoperative computed tomography scans in operative planning for malleolar ankle fractures", Foot Ankle Int, 34, pp.697~704 (2013)

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