Fractures of the talus and calcaneus: Evaluation by computed tomography

Hindman, Bernard W.; Ross, Steven; Sowerby, Maren R.R.

doi:10.1016/0149-936x(86)90075-5

Cited by 18 publications

(8 citation statements)

References 11 publications

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“…Computed tomography scanning has been shown to be a superior modality when clinical circumstances suggest a fracture. 3,7 Titanium screws were used for fixation in order to allow for MRI scanning of the talus if AVN developed.…”

Section: Discussionmentioning

confidence: 99%

Fractures of the Talus: Experience of Two Level 1 Trauma Centers

Elgafy¹,

Ebraheim²,

Tile³

et al. 2000

Foot Ankle Int.

174

116

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Fifty-eight patients with 60 talar fractures were retrospectively reviewed. There were 39 men and 19 women. The age average was 32 (range, 14-74). Eighty six percent of the patients had multiple injuries. The most common mechanism of injury was a motor vehicle accident. Twenty-seven (45%) of the fractures were neck, 22 (36.7%) process, and 11 (18.3%) body. Forty-eight fractures had operative treatment and 12 had non-operative management. The average follow-up period was 30 months (range, 24-65). Thirty-two fractures (53.3%) developed subtalar arthritis. Two patients had subsequent subtalar fusion. Fifteen fractures (25%) developed ankle arthritis. None of these patients required ankle fusion. Fractures of the body of the talus were associated with the highest incidence of degenerative joint disease of both the subtalar and ankle joints. Ten fractures (16.6%) developed avascular necrosis (AVN), only one of which had subsequent slight collapse. Avascular necrosis occurred mostly after Hawkins Type 3 and 2 fractures of the talar neck. Three rating scores were used in this series to assess the outcome: the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, Maryland Foot Score, and Hawkins Evaluation Criteria. The outcome was different with every rating system. However, the outcome with AOFAS Ankle-Hindfoot Score and Hawkins Evaluation Criteria were almost equivalent. Assessment with the three rating scores showed that the process fractures had the best results followed by the neck and then the body fractures.

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Section: Discussionmentioning

confidence: 99%

Fractures of the Talus: Experience of Two Level 1 Trauma Centers

Elgafy¹,

Ebraheim²,

Tile³

et al. 2000

Foot Ankle Int.

174

116

View full text Add to dashboard Cite

show abstract

“…Therefore, special attention to the lateral process on the AP and mortise views is indicated to minimize a risk in delay of diagnosis and long-term symptoms. CT allows better characterization of process fractures of the talus than does plain radiography (16)(17)(18).…”

Section: Talusmentioning

confidence: 99%

Missed fractures on emergency room ankle radiographs: An analysis of 433 patients

Brandser

Braksiek

El‐Khoury

et al. 1997

Emergency Radiology

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The purpose of this study was to review fractures and radiographic abnormalities that are detectable, but often overlooked, on a standard ankle radiographic series. We carried out a retrospective review of 556 consecutive ankle radiographic series obtained between June 1, 1995, and May 31, 1996. From this population, 433 complete ankle radiographic series on patients with suspected trauma were selected. The original radiologist's interpretation was compared to a two. step "gold standard" interpretation, consisting of reinterpretation by a musculoskeletal radiologist with the patient's medical and imaging records at hand, with review of discrepant cases by a consensus panel.Eighteen studies were incorrectly interpreted at the initial reading, yielding an overall error rate of 4.2%. Fifteen of the errors were missed A nkle injuries are an extremely common reason for a visit to the emergency department; up to 12% of emergency room presentations involve an ankle injury (1). Ankle radiographs make up 10% of all radiographs obtained on emergency room patients (2). Accurate characterization of these radiographs is important for guiding patient management. Although some fractures, such as malleolar fractures, are readily identified, other injuries can be more difficult to detect. The purpose of this paper is to review our experience with emergency department ankle radiographs to assess which fracture types are most often missed and how to improve diagnostic accuracy in the emergency setting. MATERIALS AND METHODSWe retrospectively reviewed 556 consecutive ankle radiographic series obtained between June 1, 1995, and May 31, 1996, on patients from the emergency department. Studies were included only if they were a complete radiographic series, consisting of an anteroposterior (AP), lateral, and mortise view, on a patient with recent trauma and in whom no prior instrumentation or casting had been performed. Using these inclusion criteria, 41 of the 556 radiographic series were excluded for incomplete studies, 27 for casted or instrumented patients, 24 that were not ordered to evaluate trauma, and 30 studies that had missing films. In addition, one other patient was excluded as no confident gold standard could be applied (described below). As a result, 433 ankle radiographic series were reviewed from this consecutive retrospective series.The original radiologist's interpretation was compared to a "gold standard" interpretation.The gold standard reading consisted of a two-step process, with an initial review by a musculoskeletal radiologist, who was supplied with each patient's subsequent studies, including plain radiographs, computed Emergency Radiology 9

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“…Computed tomography is essential for preoperative evaluation of intra-articular calcaneal tractures.l'' [7][8][9][10][12][13][14][15][16][17][18][19] Coronal CT images help evaluate superior posterior facet disruption, sustentaculum tali depression, peroneal or flexor hallucis tendon entrapment, and widening and loss of calcaneal height. Axial CT images show disruption of the inferior part of the posterior facet, calcaneocuboid joint involvement, and widening of the calcaneus."…”

Section: Discussionmentioning

confidence: 99%

A Pitfall of Coronal Computed Tomographic Imaging in Evaluation of Calcaneal Fractures

et al. 1996

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Computed tomographic (CT) coronal images of the posterior talocalcaneal joint were compared with lateral radiographic views and intraoperative findings in 35 patients with 36 intra-articular calcaneal fractures. The severity of articular incongruity and rotational displacement of the posterior facet fragment were not well appreciated in coronal CT images of nine patients, although Bohler and Gissane angles were significantly decreased in lateral radiographs. This disparity between the radiographic and coronal CT scans can be explained by the intraoperative finding of rotation of the fractured central or lateral portion of the convex posterior calcaneal facet along a horizontal axis in the coronal plane.

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Fractures of the talus and calcaneus: Evaluation by computed tomography

Cited by 18 publications

References 11 publications

Fractures of the Talus: Experience of Two Level 1 Trauma Centers

Fractures of the Talus: Experience of Two Level 1 Trauma Centers

Missed fractures on emergency room ankle radiographs: An analysis of 433 patients

A Pitfall of Coronal Computed Tomographic Imaging in Evaluation of Calcaneal Fractures

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