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Comparative Study
. 2024 Aug 30;17(1):238.
doi: 10.1186/s13104-024-06902-9.

Evaluation of treatment planning discrepancies: CT versus plain radiographic findings in patients with foot and ankle trauma

Seyed Hadi Kalantar  1 , Nima Bagheri  1 , Nesa Milan  1 , Sare Moslemi Mehni  2 , Iman Menbari Oskouie  3 , Tina Alinia  1 , Nazanin Rahimdoost  4
Affiliations
Comparative Study

Evaluation of treatment planning discrepancies: CT versus plain radiographic findings in patients with foot and ankle trauma

Seyed Hadi Kalantar et al. BMC Res Notes. .

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.

Keywords: Computed tomography; Diagnostic accuracy; Foot and ankle trauma; Plain radiography; Treatment planning.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
A 29 year-old male presenting with a history of motor vehicle accident with complaint of foot and ankle swelling and pain. The plain radiography seems normal (1–3), but with a closer look at the patient’s CT, fractures of the cuboid (4), 4th metatarsal (5), and comminuted fracture of talus (6,7) can be detected (red arrows). This patient has to be managed operatively based on CT findings
See this image and copyright information in PMC

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References

    1. Amin S, et al. Trends in fracture incidence: a Population-based study over 20 years. J Bone Miner Res. 2014;29(3):581–9. 10.1002/jbmr.2072 - DOI - PMC - PubMed
    1. Mattijssen-Horstink L, et al. Radiologic discrepancies in diagnosis of fractures in a Dutch teaching emergency department: a retrospective analysis. Scand J Trauma Resusc Emerg Med. 2020;28(1):38. 10.1186/s13049-020-00727-8 - DOI - PMC - PubMed
    1. Bancroft LW, et al. ACR appropriateness Criteria Acute Trauma to the Foot. J Am Coll Radiol. 2015;12(6):575–81. 10.1016/j.jacr.2015.02.018 - DOI - PubMed
    1. Russo A, et al. Ankle fracture: radiographic approach according to the Lauge-Hansen classification. Musculoskelet Surg. 2013;97(Suppl 2):S155–60. 10.1007/s12306-013-0284-x - DOI - PubMed
    1. Goost H, et al. Fractures of the Ankle Joint. Deutsches Aerzteblatt Online; 2014. - PMC - PubMed

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