title: Does the addition of computed tomography to computed radiography provide more value to final outcomes and treatment decisions in displaced intra-articular calcaneal fractures?
abstract: BACKGROUND
  Little is known about the additional prognostic value of computed tomography (CT) in addition to computed radiography in displaced intra-articular calcaneal fractures. Thepresent study was undertaken to examine and compare the final radiographic outcomes and the prevalence of treatment methods of displaced intra-articular calcaneal fractures in patients with preoperative computed radiography alone vs. a combination ofcomputed radiography and computed tomogra- phy.
  
  
  METHODS
  Thirty-four patients with 38 displaced intra-articular calcaneal fractures were divided into two groups: a group that was evaluated with computed tomography and computed radiography (17 patients; 20 fractures) and a group that was evaluated with computed radiography alone (17 patients; 18 fractures). Patient demographics, pre- operative and postoperative Bohler's angles, and fracture classifications were recorded. Postoperative outcomes were evaluated using calcanealfracture radiographic scores (modified Zwipp score).
  
  
  RESULTS
  The mean age ofour patients in the present study was 43.3 ± 12.3 years. The mean age ofthe patients in the computed tomography group (48.4 ± 11.6 years) was significantly higher than that of the non-computed tomography group (37.6 ± 10.7 years, p = 0.005). The mean follow-up time was 17.4 ± 9.8 months. There was a significantly higher prevalence of open reduction and internalfixation in the computed tomography group versus the non-computed tomography group (p = 0.019). However there was no significant difference observed for the mean radiographic scores. Postoperatively, outcomes were satisfactory in both groups, although intra-articular alignment was significantly better in the computed tomography group (p = 0.020).
  
  
  CONCLUSIONS
  The overall outcomes were comparable between the patient groups with computed tomography vs. those without computed tomography, exceptfor the superiority of postoperative intra-articular alignment in patients with computed tomography. Open reduction and internal fixation were more frequently performed in the patients with computed tomography than patients without computed tomography.
authors.forename: Chayanin
authors.initials: C
authors.lastname: Angthong
authors.forename: Akekapong
authors.initials: A
authors.lastname: Atikomchaiwong
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshimura
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kanazawa
authors.forename: Thos
authors.initials: T
authors.lastname: Hamrnroongroj
authors.forename: Wirana
authors.initials: W
authors.lastname: Angthong
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Hagio
authors.forename: Akinori
authors.initials: A
authors.lastname: Takeyama
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Naito
mesh_terms: D000328:Adult; D002111:Calcaneus / Q000293:injuries* / Q000601:surgery; D003657:Decision Making; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed