Evaluation of Intra-articular Fracture Extension After Gunshot Wounds to the Lower Extremity: Plain Radiographs Versus Computer Tomography
This study was to compare the use of computer tomography with plain radiographs for the evaluation of intra-articular extension of long bone fractures in the lower extremity after low-energy gunshot wounds. Retrospective chart and radiographic review. Level 1 Trauma Center. Data were collected from...
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Published in | Journal of orthopaedic trauma Vol. 31; no. 6; p. 334 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.06.2017
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Abstract | This study was to compare the use of computer tomography with plain radiographs for the evaluation of intra-articular extension of long bone fractures in the lower extremity after low-energy gunshot wounds.
Retrospective chart and radiographic review.
Level 1 Trauma Center.
Data were collected from a single institution from 2000 to 2014. Inclusion criteria consisted of patients greater than 17 years of age, low-velocity gunshot injuries causing fracture of the femur or tibia, plain radiographs with adequate films, and computed tomography (CT) imaging of the fracture. This consisted of 133 patients with 140 fractures.
Intra-articular fracture extension was evaluated on initial plain radiographs and CTs.
Comparison of "gold standard" CT with all reviewers' evaluation of plain radiographs.
There were 140 total fractures; 108 were femoral fractures and 32 were tibial fractures. By comparing plain radiographs with the gold standard CT, the reviewers demonstrated correct diagnosis in 85% of intra-articular fractures and 96% of non-intra-articular fractures. In addition, the reviewers accurately diagnosed 70.8% of intra-articular extensions in the diaphysis and 70.5% in the metaphysis. The sensitivity and specificity for plain radiographs were 85.3% and 96.0%, respectively, for all locations. Metaphyseal and diaphyseal fractures demonstrated the poorest sensitivity at 80.7% and 82.1%, respectively.
Low-energy gunshot wounds with fractures in the diaphyseal of the distal femur and all metaphyseal fractures warrant CT evaluation to better examine for intra-articular fracture extension.
Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence. |
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AbstractList | This study was to compare the use of computer tomography with plain radiographs for the evaluation of intra-articular extension of long bone fractures in the lower extremity after low-energy gunshot wounds.
Retrospective chart and radiographic review.
Level 1 Trauma Center.
Data were collected from a single institution from 2000 to 2014. Inclusion criteria consisted of patients greater than 17 years of age, low-velocity gunshot injuries causing fracture of the femur or tibia, plain radiographs with adequate films, and computed tomography (CT) imaging of the fracture. This consisted of 133 patients with 140 fractures.
Intra-articular fracture extension was evaluated on initial plain radiographs and CTs.
Comparison of "gold standard" CT with all reviewers' evaluation of plain radiographs.
There were 140 total fractures; 108 were femoral fractures and 32 were tibial fractures. By comparing plain radiographs with the gold standard CT, the reviewers demonstrated correct diagnosis in 85% of intra-articular fractures and 96% of non-intra-articular fractures. In addition, the reviewers accurately diagnosed 70.8% of intra-articular extensions in the diaphysis and 70.5% in the metaphysis. The sensitivity and specificity for plain radiographs were 85.3% and 96.0%, respectively, for all locations. Metaphyseal and diaphyseal fractures demonstrated the poorest sensitivity at 80.7% and 82.1%, respectively.
Low-energy gunshot wounds with fractures in the diaphyseal of the distal femur and all metaphyseal fractures warrant CT evaluation to better examine for intra-articular fracture extension.
Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence. |
Author | Reilly, Mark C Sirkin, Michael S Hwang, John S Adams, Mark R Lelkes, Valdis Koury, Kenneth L Gorgy, George |
Author_xml | – sequence: 1 givenname: John S surname: Hwang fullname: Hwang, John S organization: Department of Orthopaedic Surgery, Rutgers, New Jersey Medical School, The State University of New Jersey, Newark, NJ – sequence: 2 givenname: Kenneth L surname: Koury fullname: Koury, Kenneth L – sequence: 3 givenname: George surname: Gorgy fullname: Gorgy, George – sequence: 4 givenname: Michael S surname: Sirkin fullname: Sirkin, Michael S – sequence: 5 givenname: Mark C surname: Reilly fullname: Reilly, Mark C – sequence: 6 givenname: Valdis surname: Lelkes fullname: Lelkes, Valdis – sequence: 7 givenname: Mark R surname: Adams fullname: Adams, Mark R |
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CitedBy_id | crossref_primary_10_1016_j_nurpra_2019_06_019 crossref_primary_10_1111_evj_13441 crossref_primary_10_3390_medicina55100623 crossref_primary_10_1016_j_injury_2017_09_022 crossref_primary_10_26724_2079_8334_2019_3_69_168_173 crossref_primary_10_1097_BOT_0000000000002004 crossref_primary_10_1016_j_injury_2020_01_034 crossref_primary_10_2106_JBJS_RVW_22_00153 |
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SubjectTerms | Adolescent Adult Aged Aged, 80 and over Causality Child Comorbidity Female Humans Incidence Intra-Articular Fractures - diagnostic imaging Intra-Articular Fractures - epidemiology Leg Injuries - diagnostic imaging Leg Injuries - epidemiology Male Middle Aged Ohio - epidemiology Reproducibility of Results Retrospective Studies Risk Factors Sensitivity and Specificity Tomography, X-Ray Computed - utilization Treatment Outcome Wounds, Gunshot - diagnostic imaging Wounds, Gunshot - epidemiology X-Ray Film - utilization Young Adult |
Title | Evaluation of Intra-articular Fracture Extension After Gunshot Wounds to the Lower Extremity: Plain Radiographs Versus Computer Tomography |
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