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Comparative Study
. 2015 Jun 13:16:144.
doi: 10.1186/s12891-015-0608-0.

The effect of three-dimensional computed tomography reconstructions on preoperative planning of tibial plateau fractures: a case-control series

Andrew Dodd  1   2 , Elizabeth Oddone Paolucci  3 , Robert Korley  4
Affiliations
Comparative Study

The effect of three-dimensional computed tomography reconstructions on preoperative planning of tibial plateau fractures: a case-control series

Andrew Dodd et al. BMC Musculoskelet Disord. .

Abstract

Background: Tibial plateau fractures are a common intra-articular injury for which computed tomography (CT) scans are routinely used for preoperative planning. Three-dimensional reconstructions of CT scans have been increasingly investigated in recent years, however their role has yet to be defined. We wish to investigate the role of three-dimensional computed tomography reconstructions (3D-CT) in the preoperative planning of tibial plateau fractures.

Methods: Twelve cases of tibial plateau fractures including plain film radiographs and conventional CT scans were distributed to 21 observers (orthopaedic residents and consultants). The observers filled out a preoperative plan checklist created for this study. Three months later the same cases were distributed, in random order, this time including 3D-CT reconstructions. The same preoperative checklists were completed, and compared to the previous checklists.

Results: The preoperative plan checklist was able to detect differences between cases and between observers. No significant differences were detected between the total plan scores when comparing conventional CT to 3D-CT. Sub-analysis of plan specifics (incisions, hardware, adjuncts) was also not significantly different. The level of training of the observer or the fracture complexity did not affect these results.

Conclusions: No significant changes were made to observer's preoperative plans with the addition of 3D-CT. 3D-CT reconstructions come at a cost to the system, and therefore their usefulness should be investigated prior to widespread use. Our study demonstrates that the addition of 3D-CT reconstructions to the preoperative workup of tibial plateau fractures did not change management plans when compared to plans made using traditional CT-scans.

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Figures

Fig. 1
Fig. 1
Change in mean total score from 2D-CT to 3D-CT based on level of training
Fig. 2
Fig. 2
Mean total scores based on fracture complexity and plan type
See this image and copyright information in PMC

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