Comparison between standard radiography and spiral CT with 3D reconstruction in the evaluation, classification and management of tibial plateau fractures
S. Wicky et al., Comparison between standard radiography and spiral CT with 3D reconstruction in the evaluation, classification and management of tibial plateau fractures, EUR RADIOL, 10(8), 2000, pp. 1227-1232
The aim of this study was to compare the diagnostic efficiency of plain fil
m and spiral CT examinations with 3D reconstructions of 42 tibial plateau f
ractures and to assess the accuracy of these two techniques in the pre-oper
ative surgical plan in 22 cases. Forty-two tibial plateau fractures were ex
amined with plain film (anteroposterior, lateral, two obliques) and spiral
CT with surface-shaded-display 3D reconstructions. The Swiss AO-ASIF classi
fication system of bone fracture from Muller was used. In 22 cases the surg
ical plans and the sequence of reconstruction of the fragments were prospec
tively determined with both techniques, successively, and then correlated w
ith the surgical reports and post-operative plain film, The fractures were
underestimated with plain film in 18 of 42 cases (43 %). Due to the spiral
CT 3D reconstructions, and precise pre-operative information, the surgical
plans based on plain film were modified and adjusted in 13 cases among 22 (
59 %). Spiral CT 3D reconstructions give a better and more accurate demonst
ration of the tibial plateau fracture and allows a more precise pre-operati
ve surgical plan.