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Evaluation of Treatment Planning Discrepancies: Ct Versus Plain Radiographic Findings in Patients With Foot and Ankle Trauma Publisher Pubmed



Kalantar SH1 ; Bagheri N1 ; Milan N1 ; Mehni SM2 ; Oskouie IM4 ; Alinia T1 ; Rahimdoost N3
Authors
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Authors Affiliations
  1. 1. Department of Orthopedic and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Research Notes Published:2024


Abstract

Abstract: This study aimed to compare the findings of plain radiography and computed tomography (CT) of foot and ankle in patients submitted to the emergency department with high-energy foot and ankle trauma, to demonstrate if missing fractures on plain radiographs will significantly alter the treatment plan considered for each patient based on the findings of each imaging modality. We retrospectively observed standard radiological foot and ankle x-rays and CT scans in patients who presented to our center from April 2019 to June 2020 with a history of foot and ankle trauma with either loss of consciousness, a history of high-energy trauma, or clinical presentation disproportionate to plain radiographic findings. We investigated the number of fractures of each bone detected on plain radiographs and CT scans and the treatments based on each modality’s findings in patients admitted to our center. Sixty-five out of 163 (39.87%) included in our study had at least one missed fracture on plain radiography that was detected on CT. Thirty-one (19%) patients had normal radiography despite actually having fractures. In 38 (23.31%) patients CT changed the treatment plan decided by our surgeons (P < 0.001). The two imaging modalities had a moderate agreement for detecting foot and ankle fractures overall (κ = 0.432). The failure to detect fractures in patients with high-energy trauma can significantly impact treatment effectiveness. Integrating CT scans into the diagnostic process can lead to changes in treatment planning and ultimately improve patient outcomes. Level of clinical evidence: IV. © The Author(s) 2024.