How to improve the performance of acetabulum fracture diagnoses: investigating the use of three-dimensional CT-scan reconstructions

• Published in: Emergency radiology Vol. 29; no. 5; pp. 863 - 871
• Main Authors: Minet, Camille, Reina, Nicolas, Gracia, Gautier, Lapègue, Franck, Sans, Nicolas, Faruch-Bilfeld, Marie
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2022; Springer Nature B.V
• Subjects: Agreements; Bone surgery; Classification; Computed tomography; Demographics; Diagnosis; Emergency Medicine; Fractures; Imaging; Medical diagnosis; Medical imaging; Medicine; Medicine & Public Health; Older people; Original Article; Orthopedics; Radiology; Software; Surgeons; Trauma; Two dimensional analysis; Three-dimensional CT-scan reconstructions; Acetabulum fractures; Letournel and Judet classification
• ISSN: 1070-3004; 1438-1435
• DOI: 10.1007/s10140-022-02068-8

Purpose The classification of acetabular fractures remains a challenge for the junior radiologist, although he is the first line of diagnosis in Emergency Department. The advantages of three-dimensional reconstructions have yet to be evaluated on a large scale. Method A total of 212 fractures were classified according to Letournel and Judet by a senior orthopaedic surgeon, a senior radiologist, and a resident radiologist. The CT scans were first analysed in 2D and then a second time using 2D + 3D reconstructions of the acetabulum excluding the femoral head. Results 3D reconstructions improved correct classification not only for the radiologist resident (+ 5%) but also for senior radiologist and orthopaedist (+ 2 and + 3%). 3D reconstructions also more significantly improved the diagnoses of complex fractures (+ 8.3%) compared to simple fractures (+ 0.4%). Conclusions 3D reconstructions have improved the routine diagnosis of acetabular fractures, especially for junior radiologist or in cases of complex fractures.