3D-CT imagistic for diagnosis assessment and orthopedic treatment of articular fractures with relevance for patient functional rehabilitation

Abstract

Background: The aim of the study was to determine the contribution of 3-dimensional computer tomography (3D-CT) in the diagnosis of the articular fractures compared with X-rays and computer tomography (CT), and to establish if 3D-CT can confirm or modify the preoperative plans. Methods: We have conducted a retrospective study between 2020 - 2022, 46 patients with articular fractures. We have asked 5 independent surgeons to make comparative analyses of the information required for a correct diagnosis and preoperative planning, obtained from X-ray, CT and 3D-CT. Each time, the surgeon was requested to categorize the fracture using specific classification systems and articulate their recommended treatment approach. Results: The study showed us the importance of 3D-CT to achieve a correct diagnosis for the articular fractures by ana-lyzing the discrepancies between X-ray, CT and 3D-CT, with direct influence upon the presurgical plan. In 37% of the cases, fracture lines were not apparent on X-rays but were visible on CT scans. However, in more than 27% of these instances, specific bone injuries, like central articular depression or unique split-comminution patterns, were not evident on standard CT scans but could be identified using 3D-CT scans. Conclusions: To establish the correct diagnosis and the proper therapeutical plan for the articular fractures, it is necessary to make a complete ra-diological evaluation, which consists of X-ray, CT and 3D-CT.

Keywords

• diagnosis
• treatment
• computed tomography
• tridimensional reconstruction
• planning