Dataset Information

Identification of Postoperative Step-Offs and Gaps With Broden's View Following Open Reduction and Internal Fixation of Calcaneal Fractures.

ABSTRACT:

Background

To date, there is no consensus regarding which postoperative imaging technique should be used after open reduction and internal fixation of an intra-articular calcaneal fracture. The aim of this study was to clarify whether Brodén's view is sufficient as postoperative radiologic examination to assess step-offs and gaps of the posterior facet.

Methods

Six observers estimated the size of step-offs and gaps on Brodén's view in 42 surgically treated intra-articular calcaneal fractures. These findings were compared to postoperative CT scans (gold standard). Inter- and intraobserver reliability were calculated and compared using intraclass correlation coefficients (ICCs).

Results

An accuracy of approximately 75% for both step-offs and gaps was found in foot and ankle experts. Less experienced observers correctly identified step-offs and gaps in approximately 62% of cases on fluoroscopy and in 48% on radiographs. Interobserver reliability for intraoperative fluoroscopy as well as postoperative radiographs was fair for step-offs, whereas interobserver reliability for gaps was excellent. Intraobserver reliability showed a low level of agreement for intraoperative fluoroscopy, in contrast to postoperative radiographs with excellent agreement for step-offs and good agreement for gaps.

Conclusion

Our results show that especially for more experienced foot and ankle surgeons, in the majority of fractures, Brodén's view accurately showed step-offs and gaps following open reduction and internal fixation. Interobserver reliability showed a fair level of agreement for step-offs and excellent agreement for gaps. Intraobserver reliability was only enough for radiographs, not for fluoroscopy.

Level of evidence

Level IV, case series.

SUBMITTER: Looijen RC

PROVIDER: S-EPMC6610549 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Identification of Postoperative Step-Offs and Gaps With Brodén's View Following Open Reduction and Internal Fixation of Calcaneal Fractures.

Looijen Rosalie C RC Misselyn Dominique D Backes Manouk M Dingemans Siem A SA Halm Jens A JA Schepers Tim T

Foot & ankle international 20190408 7

<h4>Background</h4>To date, there is no consensus regarding which postoperative imaging technique should be used after open reduction and internal fixation of an intra-articular calcaneal fracture. The aim of this study was to clarify whether Brodén's view is sufficient as postoperative radiologic examination to assess step-offs and gaps of the posterior facet.<h4>Methods</h4>Six observers estimated the size of step-offs and gaps on Brodén's view in 42 surgically treated intra-articular calcanea ...[more]

PMID: 30957544

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