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2014 ; 6
(1
): 13-7
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Diagnostic accuracy of two-dimensional and three-dimensional imaging and modeling
of radial head fractures
#MMPMID24876684
Guitton TG
; Brouwer K
; Lindenhovius AL
; Dyer G
; Zurakowski D
; Mudgal CS
; Ring DC
J Hand Microsurg
2014[Jun]; 6
(1
): 13-7
PMID24876684
show ga
To tests the hypothesis that classification and characterization of fractures of
the radial head is more accurate with 3D than 2D computed tomography images and
radiographs, using a prospective study design with intraoperative inspection as
the reference standard. Treating surgeons and first assistants completed a
questionnaire assigning a fracture type according to the Broberg and Morrey
modification of Mason's classification, evaluating selected fracture
characteristics, and electing preferred management based upon radiographs and 2D
images alone; then adding 3D-CT; then 3D printed physical models; and finally
intra-operative visualization. The addition of the 3D CT and physical models
improved the sensitivity for fracture line separating the entire head from the
neck, comminution of the radial neck, fracture involving the articular surface,
articular fracture gap greater than 2 mm, impacted fracture fragments, greater
than 3 articular fragments, and articular fragments judged too small to repair.
There were no significant differences in diagnostic performance with the addition
of 3D models. The addition of 3D CT and models improved the reliability of
Broberg and Morrey classification. We conclude that 3DCT and 3D physical modeling
provide more accurate fracture classification and characterization of fracture of
the radial head with less proposed variability in treatment. We did not
demonstrate a clear advantage for modeling over 3DCT reconstructions. LEVEL OF
EVIDENCE: Diagnostic, Level I.