Evaluation of computed tomography post-processing images in postoperative assessment of Lisfranc injuries compared with plain radiographs

Abstract

Background: The objective of this study is to evaluate the value of computed tomography (CT) post-processing images in postoperative assessment of Lisfranc injuries compared with plain radiographs. Methods: A total of 79 cases with closed Lisfranc injuries that were treated with conventional open reduction and internal fixation from January 2010 to June 2016 were analyzed. Postoperative assessment was performed by two independent orthopedic surgeons with both plain radiographs and CT post-processing images. Inter- and intraobserver agreement were analyzed by kappa statistics while the differences between the two postoperative imaging assessments were assessed using the X2 test (McNemar's test). Significance was assumed when p < 0.05. Results: Inter- and intra-observer agreement of CT post-processing images was much higher than that of plain radiographs. Non-anatomic reduction was more easily identified in patients with injuries of Myerson classifications A, B1, B2, and C1 using CT post-processing images with overall groups (p < 0.05), and poor internal fixation was also more easily detected in patients with injuries of Myerson classifications A, B1, B2, and C2 using CT post-processing images with overall groups (p < 0.05). Conclusions: CT post-processing images can be more reliable than plain radiographs in the postoperative assessment of reduction and implant placement for Lisfranc injuries.