Computer-Reconstructed Radiographs Are as Good as Plain Radiographs for Assessment of Acetabular Fractures
Joseph Borrelli, Jr., MD, Michael Peelle, MD, Elizabeth McFarland, MD, Bradley Evanoff, MD, and William M. Ricci, MD
Dr. Borrelli is Professor and Chairman, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Dr. Peelle is with the 88th Surgical Operations Squadron, Wright Patterson Air Force Base, Ohio.
Dr. McFarland is Associate Professor, Mallinckrodt Institute of Radiology, Dr. Evanoff is Associate Professor, Division of General Medical Sciences, Department of Medicine, and Dr. Ricci is Associate Professor, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
Radiographic evaluation of acutely injured patients with a displaced acetabular fracture usually includes plain radiographs and computed tomography (CT) scans. Because of patient and technologist factors, plain radiographs can be compromised and therefore can be insufficient for assessment of the fractured acetabulum.
We conducted a study to determine whether computer-reconstructed radiographs (CRRs), plain radiograph–like images created from CT data, are equivalent to traditional radiographs for assessment of acetabular fractures. Five orthopedic surgeons with various trauma experience compared 77 radiographic images from 11 retrospectively identified patients with a displaced acetabular fracture.
CRRs were found to be equal to plain radiographs for fracture pattern recognition, image clarity, level of information provided, and overall reviewer satisfaction. Reviewers were confident in their ability to assess fractures using CRRs and found them more aesthetically pleasing than plain radiographs.
CRRs provide information equal to that of plain radiographs for assessment of displaced acetabular fractures and have the potential to overcome the problems associated with patient factors (discomfort, body habitus, fracture pattern, presence of overlying osseous structures, bowel gas and intestinal contrast materials) and technologist factors.