Ankle CT scan allows better management of posterior malleolus fractures than X-rays
Purpose Undiagnosed and undertreated posterior malleolus fractures lead to early ankle instability and arthritis. A preoperative CT scan could improve the management of those fractures. This study assessed the benefits of a systematic ankle CT scanner to diagnose and manage posterior malleolus fract...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2022-10, Vol.32 (7), p.1301-1309 |
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| container_title | European journal of orthopaedic surgery & traumatology |
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| creator | Bouche, Pierre-Alban Gaujac, Nicolas Corsia, Simon Leclerc, Philippe Anract, Philippe Auberger, Guillaume |
| description | Purpose
Undiagnosed and undertreated posterior malleolus fractures lead to early ankle instability and arthritis. A preoperative CT scan could improve the management of those fractures. This study assessed the benefits of a systematic ankle CT scanner to diagnose and manage posterior malleolus fracture.
Methods
A monocentric retrospective cohort study was conducted. Sixty consecutive patients with bimalleolar fractures were operated and underwent a preoperative CT scan. The mean age was 50.0 years old (18.6 years old) with a mean body mass index of 20.3 (kg/m
2
) (11.4 kg/m
2
) and 71.7% (43/60) of women. The primary outcome was the rate of posterior malleolus fragment diagnosed on X-rays and on CT scan. Secondly, interobserver and interobserver’s agreement were compared between conventional X-rays and CT scan.
Results
Thirty-five (58.3%) posterior fragment fractures were observed on X-rays and 53 (88.3%) on the preoperative CT scan (
p
|
| doi_str_mv | 10.1007/s00590-021-03104-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2568249570</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2708604282</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-eb6a9a223dc9e8bbdc4c4531b9e805619332179df86b7bb496e9091475d8a6063</originalsourceid><addsrcrecordid>eNp9kE9LxDAQxYsouK5-AU8BL16qk6RJm-Oy-A8WPLiCt5Ck6bprtlmTFum3N2sFxYOnmXn83mN4WXaO4QoDlNcRgAnIgeAcKIYiHw6yCS4oyTHw6vDXfpydxLgBwExgNsmeZu2bs2i-RNGoFinn_EdE2nadDWirWrWyW9t2yDdo52MS136vO2e96yNqgjJdH2xE3Wuyv-RBDfE0O2qUi_bse06z59ub5fw-XzzePcxni9xQRrrcaq6EIoTWRthK69oUpmAU63QB41hQSnAp6qbiutS6ENwKELgoWV0pDpxOs8sxdxf8e29jJ7fraKxzqrW-j5IwXpFCsBISevEH3fg-tOk7SUqoOBSkIokiI2WCjzHYRu7CeqvCIDHIfc9y7FmmnuVXz3JIJjqaYoLblQ0_0f-4PgGITn_7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2708604282</pqid></control><display><type>article</type><title>Ankle CT scan allows better management of posterior malleolus fractures than X-rays</title><source>SpringerLink Journals</source><creator>Bouche, Pierre-Alban ; Gaujac, Nicolas ; Corsia, Simon ; Leclerc, Philippe ; Anract, Philippe ; Auberger, Guillaume</creator><creatorcontrib>Bouche, Pierre-Alban ; Gaujac, Nicolas ; Corsia, Simon ; Leclerc, Philippe ; Anract, Philippe ; Auberger, Guillaume</creatorcontrib><description>Purpose
Undiagnosed and undertreated posterior malleolus fractures lead to early ankle instability and arthritis. A preoperative CT scan could improve the management of those fractures. This study assessed the benefits of a systematic ankle CT scanner to diagnose and manage posterior malleolus fracture.
Methods
A monocentric retrospective cohort study was conducted. Sixty consecutive patients with bimalleolar fractures were operated and underwent a preoperative CT scan. The mean age was 50.0 years old (18.6 years old) with a mean body mass index of 20.3 (kg/m
2
) (11.4 kg/m
2
) and 71.7% (43/60) of women. The primary outcome was the rate of posterior malleolus fragment diagnosed on X-rays and on CT scan. Secondly, interobserver and interobserver’s agreement were compared between conventional X-rays and CT scan.
Results
Thirty-five (58.3%) posterior fragment fractures were observed on X-rays and 53 (88.3%) on the preoperative CT scan (
p
< 0.01). The intraobserver reproducibility for X-rays was low (0.02 [− 0.23; 0.27]) and moderate for CT scan (0.45 [0.0; 0.84]). The interobserver reproducibility for X-rays was moderate (0.39 [0.15; 0.60]) and excellent for CT scan (0.78 [0.0; 1.0]).
Conclusion
A wide proportion of bimalleolar fractures are associated with posterior malleolus fractures and undiagnosed with standard X-rays. We advocate a systematic preoperative CT scan in the management of bimalleolar fractures.
Level of evidence
Level IV, retrospective cohort study.
Trial registration number
2218999v0, date of registration: 11/08/2020 (retrospectively registered).</description><identifier>ISSN: 1432-1068</identifier><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-021-03104-y</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Ankle ; Cohort analysis ; Medical imaging ; Medicine ; Medicine & Public Health ; Original Article ; Reproducibility ; Surgical Orthopedics ; Traumatic Surgery ; X-rays</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2022-10, Vol.32 (7), p.1301-1309</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-eb6a9a223dc9e8bbdc4c4531b9e805619332179df86b7bb496e9091475d8a6063</citedby><cites>FETCH-LOGICAL-c352t-eb6a9a223dc9e8bbdc4c4531b9e805619332179df86b7bb496e9091475d8a6063</cites><orcidid>0000-0002-4117-4651</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-021-03104-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-021-03104-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Bouche, Pierre-Alban</creatorcontrib><creatorcontrib>Gaujac, Nicolas</creatorcontrib><creatorcontrib>Corsia, Simon</creatorcontrib><creatorcontrib>Leclerc, Philippe</creatorcontrib><creatorcontrib>Anract, Philippe</creatorcontrib><creatorcontrib>Auberger, Guillaume</creatorcontrib><title>Ankle CT scan allows better management of posterior malleolus fractures than X-rays</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Purpose
Undiagnosed and undertreated posterior malleolus fractures lead to early ankle instability and arthritis. A preoperative CT scan could improve the management of those fractures. This study assessed the benefits of a systematic ankle CT scanner to diagnose and manage posterior malleolus fracture.
Methods
A monocentric retrospective cohort study was conducted. Sixty consecutive patients with bimalleolar fractures were operated and underwent a preoperative CT scan. The mean age was 50.0 years old (18.6 years old) with a mean body mass index of 20.3 (kg/m
2
) (11.4 kg/m
2
) and 71.7% (43/60) of women. The primary outcome was the rate of posterior malleolus fragment diagnosed on X-rays and on CT scan. Secondly, interobserver and interobserver’s agreement were compared between conventional X-rays and CT scan.
Results
Thirty-five (58.3%) posterior fragment fractures were observed on X-rays and 53 (88.3%) on the preoperative CT scan (
p
< 0.01). The intraobserver reproducibility for X-rays was low (0.02 [− 0.23; 0.27]) and moderate for CT scan (0.45 [0.0; 0.84]). The interobserver reproducibility for X-rays was moderate (0.39 [0.15; 0.60]) and excellent for CT scan (0.78 [0.0; 1.0]).
Conclusion
A wide proportion of bimalleolar fractures are associated with posterior malleolus fractures and undiagnosed with standard X-rays. We advocate a systematic preoperative CT scan in the management of bimalleolar fractures.
Level of evidence
Level IV, retrospective cohort study.
Trial registration number
2218999v0, date of registration: 11/08/2020 (retrospectively registered).</description><subject>Ankle</subject><subject>Cohort analysis</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Reproducibility</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><subject>X-rays</subject><issn>1432-1068</issn><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kE9LxDAQxYsouK5-AU8BL16qk6RJm-Oy-A8WPLiCt5Ck6bprtlmTFum3N2sFxYOnmXn83mN4WXaO4QoDlNcRgAnIgeAcKIYiHw6yCS4oyTHw6vDXfpydxLgBwExgNsmeZu2bs2i-RNGoFinn_EdE2nadDWirWrWyW9t2yDdo52MS136vO2e96yNqgjJdH2xE3Wuyv-RBDfE0O2qUi_bse06z59ub5fw-XzzePcxni9xQRrrcaq6EIoTWRthK69oUpmAU63QB41hQSnAp6qbiutS6ENwKELgoWV0pDpxOs8sxdxf8e29jJ7fraKxzqrW-j5IwXpFCsBISevEH3fg-tOk7SUqoOBSkIokiI2WCjzHYRu7CeqvCIDHIfc9y7FmmnuVXz3JIJjqaYoLblQ0_0f-4PgGITn_7</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Bouche, Pierre-Alban</creator><creator>Gaujac, Nicolas</creator><creator>Corsia, Simon</creator><creator>Leclerc, Philippe</creator><creator>Anract, Philippe</creator><creator>Auberger, Guillaume</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4117-4651</orcidid></search><sort><creationdate>20221001</creationdate><title>Ankle CT scan allows better management of posterior malleolus fractures than X-rays</title><author>Bouche, Pierre-Alban ; Gaujac, Nicolas ; Corsia, Simon ; Leclerc, Philippe ; Anract, Philippe ; Auberger, Guillaume</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-eb6a9a223dc9e8bbdc4c4531b9e805619332179df86b7bb496e9091475d8a6063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Ankle</topic><topic>Cohort analysis</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Reproducibility</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><topic>X-rays</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bouche, Pierre-Alban</creatorcontrib><creatorcontrib>Gaujac, Nicolas</creatorcontrib><creatorcontrib>Corsia, Simon</creatorcontrib><creatorcontrib>Leclerc, Philippe</creatorcontrib><creatorcontrib>Anract, Philippe</creatorcontrib><creatorcontrib>Auberger, Guillaume</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bouche, Pierre-Alban</au><au>Gaujac, Nicolas</au><au>Corsia, Simon</au><au>Leclerc, Philippe</au><au>Anract, Philippe</au><au>Auberger, Guillaume</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ankle CT scan allows better management of posterior malleolus fractures than X-rays</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><date>2022-10-01</date><risdate>2022</risdate><volume>32</volume><issue>7</issue><spage>1301</spage><epage>1309</epage><pages>1301-1309</pages><issn>1432-1068</issn><issn>1633-8065</issn><eissn>1432-1068</eissn><abstract>Purpose
Undiagnosed and undertreated posterior malleolus fractures lead to early ankle instability and arthritis. A preoperative CT scan could improve the management of those fractures. This study assessed the benefits of a systematic ankle CT scanner to diagnose and manage posterior malleolus fracture.
Methods
A monocentric retrospective cohort study was conducted. Sixty consecutive patients with bimalleolar fractures were operated and underwent a preoperative CT scan. The mean age was 50.0 years old (18.6 years old) with a mean body mass index of 20.3 (kg/m
2
) (11.4 kg/m
2
) and 71.7% (43/60) of women. The primary outcome was the rate of posterior malleolus fragment diagnosed on X-rays and on CT scan. Secondly, interobserver and interobserver’s agreement were compared between conventional X-rays and CT scan.
Results
Thirty-five (58.3%) posterior fragment fractures were observed on X-rays and 53 (88.3%) on the preoperative CT scan (
p
< 0.01). The intraobserver reproducibility for X-rays was low (0.02 [− 0.23; 0.27]) and moderate for CT scan (0.45 [0.0; 0.84]). The interobserver reproducibility for X-rays was moderate (0.39 [0.15; 0.60]) and excellent for CT scan (0.78 [0.0; 1.0]).
Conclusion
A wide proportion of bimalleolar fractures are associated with posterior malleolus fractures and undiagnosed with standard X-rays. We advocate a systematic preoperative CT scan in the management of bimalleolar fractures.
Level of evidence
Level IV, retrospective cohort study.
Trial registration number
2218999v0, date of registration: 11/08/2020 (retrospectively registered).</abstract><cop>Paris</cop><pub>Springer Paris</pub><doi>10.1007/s00590-021-03104-y</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4117-4651</orcidid></addata></record> |
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| issn | 1432-1068 1633-8065 1432-1068 |
| language | eng |
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| source | SpringerLink Journals |
| subjects | Ankle Cohort analysis Medical imaging Medicine Medicine & Public Health Original Article Reproducibility Surgical Orthopedics Traumatic Surgery X-rays |
| title | Ankle CT scan allows better management of posterior malleolus fractures than X-rays |
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