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The effect of three-dimensional computed tomography reconstructions on preoperative planning of tibial plateau fractures: a case-control series.

Dodd A, Oddone Paolucci E, Korley R - BMC Musculoskelet Disord (2015)

Bottom Line: The same preoperative checklists were completed, and compared to the previous checklists.No significant differences were detected between the total plan scores when comparing conventional CT to 3D-CT.Sub-analysis of plan specifics (incisions, hardware, adjuncts) was also not significantly different.

View Article: PubMed Central - PubMed

Affiliation: Orthopedic Surgery Residency Training Program, University of Calgary, Calgary, Alberta, Canada. andrewedodd@gmail.com.

ABSTRACT

Background: Tibial plateau fractures are a common intra-articular injury for which computed tomography (CT) scans are routinely used for preoperative planning. Three-dimensional reconstructions of CT scans have been increasingly investigated in recent years, however their role has yet to be defined. We wish to investigate the role of three-dimensional computed tomography reconstructions (3D-CT) in the preoperative planning of tibial plateau fractures.

Methods: Twelve cases of tibial plateau fractures including plain film radiographs and conventional CT scans were distributed to 21 observers (orthopaedic residents and consultants). The observers filled out a preoperative plan checklist created for this study. Three months later the same cases were distributed, in random order, this time including 3D-CT reconstructions. The same preoperative checklists were completed, and compared to the previous checklists.

Results: The preoperative plan checklist was able to detect differences between cases and between observers. No significant differences were detected between the total plan scores when comparing conventional CT to 3D-CT. Sub-analysis of plan specifics (incisions, hardware, adjuncts) was also not significantly different. The level of training of the observer or the fracture complexity did not affect these results.

Conclusions: No significant changes were made to observer's preoperative plans with the addition of 3D-CT. 3D-CT reconstructions come at a cost to the system, and therefore their usefulness should be investigated prior to widespread use. Our study demonstrates that the addition of 3D-CT reconstructions to the preoperative workup of tibial plateau fractures did not change management plans when compared to plans made using traditional CT-scans.

No MeSH data available.


Related in: MedlinePlus

Mean total scores based on fracture complexity and plan type
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Related In: Results  -  Collection

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Fig2: Mean total scores based on fracture complexity and plan type

Mentions: When combining all cases (2D- and 3D-CT) and comparing complex to simple fractures, there is a significant difference in mean total scores (6.15 vs. 8.63, p < 0.0001). Comparing complex to simple fractures between plan types demonstrates no significant differences (p = 0.443) (Fig. 2).Fig. 2


The effect of three-dimensional computed tomography reconstructions on preoperative planning of tibial plateau fractures: a case-control series.

Dodd A, Oddone Paolucci E, Korley R - BMC Musculoskelet Disord (2015)

Mean total scores based on fracture complexity and plan type
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4465331&req=5

Fig2: Mean total scores based on fracture complexity and plan type
Mentions: When combining all cases (2D- and 3D-CT) and comparing complex to simple fractures, there is a significant difference in mean total scores (6.15 vs. 8.63, p < 0.0001). Comparing complex to simple fractures between plan types demonstrates no significant differences (p = 0.443) (Fig. 2).Fig. 2

Bottom Line: The same preoperative checklists were completed, and compared to the previous checklists.No significant differences were detected between the total plan scores when comparing conventional CT to 3D-CT.Sub-analysis of plan specifics (incisions, hardware, adjuncts) was also not significantly different.

View Article: PubMed Central - PubMed

Affiliation: Orthopedic Surgery Residency Training Program, University of Calgary, Calgary, Alberta, Canada. andrewedodd@gmail.com.

ABSTRACT

Background: Tibial plateau fractures are a common intra-articular injury for which computed tomography (CT) scans are routinely used for preoperative planning. Three-dimensional reconstructions of CT scans have been increasingly investigated in recent years, however their role has yet to be defined. We wish to investigate the role of three-dimensional computed tomography reconstructions (3D-CT) in the preoperative planning of tibial plateau fractures.

Methods: Twelve cases of tibial plateau fractures including plain film radiographs and conventional CT scans were distributed to 21 observers (orthopaedic residents and consultants). The observers filled out a preoperative plan checklist created for this study. Three months later the same cases were distributed, in random order, this time including 3D-CT reconstructions. The same preoperative checklists were completed, and compared to the previous checklists.

Results: The preoperative plan checklist was able to detect differences between cases and between observers. No significant differences were detected between the total plan scores when comparing conventional CT to 3D-CT. Sub-analysis of plan specifics (incisions, hardware, adjuncts) was also not significantly different. The level of training of the observer or the fracture complexity did not affect these results.

Conclusions: No significant changes were made to observer's preoperative plans with the addition of 3D-CT. 3D-CT reconstructions come at a cost to the system, and therefore their usefulness should be investigated prior to widespread use. Our study demonstrates that the addition of 3D-CT reconstructions to the preoperative workup of tibial plateau fractures did not change management plans when compared to plans made using traditional CT-scans.

No MeSH data available.


Related in: MedlinePlus