title: Comparison of plain radiography and CT in postoperative evaluation of ankle fractures.
abstract: OBJECTIVE
  To compare postoperative plain radiographs with computed tomography (CT) post-processing images in evaluating the quality of anatomical reduction and internal fixation of ankle fractures.
  
  
  METHODS
  A total of 168 patients who sustained closed ankle fracture and were treated with open reduction and internal fixation in East Hospital were reviewed. Postoperative plain radiographs and CT post-processing images were evaluated. The observation was performed under volume-rendering mode and multiplanar reconstruction mode. The assessment was performed by two independent orthopaedic surgeons. The inter- and intra-observer variations were analysed by kappa statistics. The differences between plain radiographs and CT post-processing images were compared using χ(2) test (McNemar's test).
  
  
  RESULTS
  Inter- and intra-observer agreement was almost perfect (0.813-1.000) using CT post-processing images, which was higher than that using plain radiographs (0.323-0.848). More non-anatomical reduction could be recognised in the supination-external rotation (SER), supination-adduction (SAD), pronation-external rotation (PER), and overall groups (p<0.05) and more poor internal fixation could be recognised in the SER, SAD, and overall groups (p<0.05) using CT post-processing images than using radiographs.
  
  
  CONCLUSIONS
  More residual articular step, fracture fragment displacement, and poor internal fixation could be detected by CT post-processing images than plain radiographs.
authors.affiliation: Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, 200120 Shanghai, China. Electronic address: cyxtongji@126.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, 200120 Shanghai, China.
authors.forename: K
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, 200120 Shanghai, China.
authors.forename: M
authors.initials: M
authors.lastname: Qiang
authors.affiliation: Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, 200120 Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, 200120 Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: Dai
mesh_terms: D000328:Adult; D000368:Aged; D064386:Ankle Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult