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Standardized three dimensional computerised tomography scanner reconstructions increase the accuracy of acetabular fracture classification

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Abstract

Purpose

Evaluate the role of four standardized 3D reconstruction views in the accurate diagnosis of acetabular fractures.

Materials and methods

Thirty-five acetabular fracture cases were selected from a tertiary centre database. Fourteen reviewers with different experience level evaluated this set of images which were provided in axial 2D views and multiplanar reconstruction (MPR) without 3D views in the first two readings then the standardized 3D views were added for the subsequent two readings. The primary outcome was the accuracy of diagnosis while inter-observer reliability and reading time as well as time needed for accurate diagnosis were evaluated.

Results

Accuracy of classification was 56.7% using the 2D and 73% using the described 3D (p < 0.001). Improvement was noted in all groups even though the expert group showed the least improvement (6.7% (p = 0.04)) and the least experience group showed the most improvement (35.7% (p < 0.001)). Average time of interpretation was 96 minutes for the 2D sets and 47 minutes for the 3D sets. Finally, the adding of the four standardized views increased the inter-observer reliability in all groups compared to the standard 2D sets with MPR.

Conclusion

Acetabular fracture diagnosis according to Letournel classification is difficult and depends greatly on the experience of the reader. The described set of 3D images yields better accuracy and renders the diagnosis more repeatable and faster. We recommend the use of these images in classifying acetabular fractures.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Groupe Hospitalier Paris Saint Joseph, 185 Rue Raymond Losserand, 75014, Paris, France

    Amer Sebaaly, Guillaume Riouallon, Mourad Zaraa, Peter Upex & Pomme Jouffroy

  2. School of Medicine, Saint Joseph University, Beirut, Lebanon

    Amer Sebaaly

  3. Department of Diagnostic Radiology, Groupe Hospitalier Paris Saint Joseph, Paris, France

    Véronique Marteau

Authors
  1. Amer Sebaaly
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  2. Guillaume Riouallon
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  3. Mourad Zaraa
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  4. Peter Upex
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  5. Véronique Marteau
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  6. Pomme Jouffroy
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Corresponding author

Correspondence to Amer Sebaaly.

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Our institutional review board approved this study and patient informed consent was not required

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The authors declare that they have no conflict of interest.

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Sebaaly, A., Riouallon, G., Zaraa, M. et al. Standardized three dimensional computerised tomography scanner reconstructions increase the accuracy of acetabular fracture classification. International Orthopaedics (SICOT) 42, 1957–1965 (2018). https://doi.org/10.1007/s00264-018-3810-5

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  • DOI: https://doi.org/10.1007/s00264-018-3810-5

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