TY - JOUR
T1 - Computed tomography reformation in evaluation of fracture healing with metallic fixation
T2 - Correlation with clinical outcome
AU - Costelloe, Colleen M.
AU - Dickson, Kyle
AU - Cody, Dianna D.
AU - Hernandez, Mike
AU - Demouy, Edward H.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2008/12
Y1 - 2008/12
N2 - BACKGROUND:: The amount of callous needed for fracture stability is typically estimated by a combination of radiographic and physical examinations. Computed tomography (CT) with sagittal and coronal reformations was performed to determine the amount of callous needed for fracture stability based on a quartile analysis of bony bridging of the circumference of the fracture site. METHODS:: All patients who received CT with sagittal and coronal reformations of a fractured tubular bone for the purpose of analyzing bony bridging over a 22-month period were retrospectively reviewed. The final analysis included 34 patients and a total of 47 examinations. Fractures were placed into one of four groups depending on the amount of cortical bridging of the circumference of the bone: group I, 0-24%, group II, 25-49%, group III, 50-74%, group IV, 75-100%. Clinical outcome was determined on the basis of fracture stability, with mean follow-up of approximately 62 weeks. RESULTS:: A statistically significant increase in clinical failure was found in patients with <25% bridging. A cut-point analysis revealed that 37.5% (6 of 16) of failures occurred among patients with <25% bony bridging, and only 9.7% (3 of 31) of failures occurred among patients with >25% bridging, corresponding to a Fisher's exact test p value of 0.045. CONCLUSIONS:: Patients with less than 25% bridging of the circumference of a tubular bone should be considered high risk for failure, indicating the need for continued protection of the site.
AB - BACKGROUND:: The amount of callous needed for fracture stability is typically estimated by a combination of radiographic and physical examinations. Computed tomography (CT) with sagittal and coronal reformations was performed to determine the amount of callous needed for fracture stability based on a quartile analysis of bony bridging of the circumference of the fracture site. METHODS:: All patients who received CT with sagittal and coronal reformations of a fractured tubular bone for the purpose of analyzing bony bridging over a 22-month period were retrospectively reviewed. The final analysis included 34 patients and a total of 47 examinations. Fractures were placed into one of four groups depending on the amount of cortical bridging of the circumference of the bone: group I, 0-24%, group II, 25-49%, group III, 50-74%, group IV, 75-100%. Clinical outcome was determined on the basis of fracture stability, with mean follow-up of approximately 62 weeks. RESULTS:: A statistically significant increase in clinical failure was found in patients with <25% bridging. A cut-point analysis revealed that 37.5% (6 of 16) of failures occurred among patients with <25% bony bridging, and only 9.7% (3 of 31) of failures occurred among patients with >25% bridging, corresponding to a Fisher's exact test p value of 0.045. CONCLUSIONS:: Patients with less than 25% bridging of the circumference of a tubular bone should be considered high risk for failure, indicating the need for continued protection of the site.
KW - Bone
KW - Computed tomography
KW - Fracture healing
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U2 - 10.1097/TA.0b013e31812eedc4
DO - 10.1097/TA.0b013e31812eedc4
M3 - Article
C2 - 19101998
AN - SCOPUS:67650603695
SN - 0022-5282
VL - 65
SP - 1421
EP - 1424
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 6
ER -