| Peer-Reviewed

3D A Retrospective Cohort Study Examining 3D Reconstruction to 2D Radiology in Identifying Rib Fractures

Received: 22 February 2017     Accepted: 22 March 2017     Published: 23 October 2017
Views:       Downloads:
Abstract

Introduction: Rib fractures are common presentations at emergency departments across the UK. 21% of emergency admissions are related to rib fractures, resulting from up to 39% of all blunt-trauma to the chest. Imaging is essential for identification of rib fractures but also for planning potential surgical intervention. The introduction of 3D imaging has enhanced the pre-surgical planning in many fields of medicine. We compared 3D CT in the identification of rib fractures to conventional 2D radiology. Methods: A retrospective cohort study of 22 patients was conducted at a district general hospital between Novembers 2014-2016. Chest X-ray, 2D CT and 3D CT findings were compared for the number of rib fractures and identification of displacement of rib fractures. Statistical analysis was performed using a 3-way ANOVA, with Cohen’s kappa statistic (κ) to identify agreement. There were 22 patients (20M: 2F) patients in this study. The mean age of patients was 50.2 ±21.7 (range 10-94). Chest X-rays had the poorest identification rate with slight agreement with 3D CT (κ=0.018). There was also a slight agreement for identification of displacement between 2D and 3D CT imaging (κ=0.127) Conclusion: Chest X-ray on its own is inferior to 2D and 3D CT. 3D CT adds to the value of 2D imaging as it gives an enhanced view of any possible fracture displacement.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 3, Issue 5)
DOI 10.11648/j.ijcts.20170305.12
Page(s) 41-52
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Rib Fractures, 3D Imaging, Chest X-ray

References
[1] Marasco, S. Lee G., Summerhayes R., Fitzgerald M., Bailey M. (2015). "Quality Of Life After Major Trauma With Multiple Rib Fractures". Injury 46.1: 61-65.
[2] Marasco, S. and Pankaj S.. (2015). "Surgical Rib Fixation – Technical Aspects". Injury 46.5, 929-932.
[3] Pulley B., Taylor B., Fowler T., Dominguez N., Trinh T. (2015)."Utility Of Three-Dimensional Computed Tomography For The Surgical Management Of Rib Fractures". Journal of Trauma and Acute Care Surgery 78.3: 530-534.
[4] Battle, C. and Evans P. (2015). "Predictors Of Mortality In Patients With Flail Chest: A Systematic Review". Emergency Medicine Journal 32.12, 961-965.
[5] May, L, Hillermann C., and Patil S. (2015). "Rib Fracture Management". BJA Education 16.1, 26-32.
[6] Bemelman M., Poeze M., Blokhuis T. J., and Leenen L. (2010). "Historic Overview Of Treatment Techniques For Rib Fractures And Flail Chest". European Journal of Trauma and Emergency Surgery 36.5, 407-415.
[7] Hoyt, J. (1901). "An Apparatus For Artificial Respiration And For Other Purposes". The Journal of Physiology 27.1-2, 48-52.
[8] Jones T., Richardson E. (1926).“Traction on the sternum in the treatment of multiple fractured ribs.” Surg Gynec Obstet. 42: 283.
[9] Bille, A., Okiror L., Karenovics W., Routledge T. (2012). "Experience With Titanium Devices For Rib Fixation And Coverage Of Chest Wall Defects". Interactive CardioVascular and Thoracic Surgery 15.4, 588-595.
[10] Schuurmans, J., Goslings J., and Schepers T. (2016). "Operative Management Versus Non-Operative Management Of Rib Fractures In Flail Chest Injuries: A Systematic Review". Eur J Trauma Emerg Surg, pp 1-6.
[11] Livingston, D., Shogan B., John P., Lavery R. (2008). "CT Diagnosis Of Rib Fractures And The Prediction Of Acute Respiratory Failure". The Journal of Trauma: Injury, Infection, and Critical Care 64.4, 905-911.
[12] Kaur, J. and Chopra R. (2010). "Three Dimensional CT Reconstruction For The Evaluation And Surgical Planning Of Mid Face Fractures: A 100 Case Study". Journal of Maxillofacial and Oral Surgery 9.4, 323-328.
[13] Esses, S. Berman, P., Bloom, A., Sosna, J. (2011). "Clinical Applications Of Physical 3D Models Derived From MDCT Data And Created By Rapid Prototyping". American Journal of Roentgenology 196.6, 683-688.
[14] McHugh, M. (2012). "Interrater Reliability: The Kappa Statistic". Biochemia Medica, 276-282.
[15] Fabricant, L., Ham B., Mullins R., Mayberry J., et al. (2013). "Prolonged Pain And Disability Are Common After Rib Fractures". The American Journal of Surgery 205.5, 511-516.
[16] Monkhouse, S. (2007) Clinical Anatomy. 2nd edition, (Edinburgh: Churchill Livingstone Print).
[17] Slobogean, G., MacPherson C., Sun T., Pelletier M., Hameed S. (2013). "Surgical Fixation Vs Nonoperative Management Of Flail Chest: A Meta-Analysis". Journal of the American College of Surgeons 216.2, 302-311.
[18] Pieracci, F. et al. (2016). "A Prospective, Controlled Clinical Evaluation Of Surgical Stabilization Of Severe Rib Fractures". Journal of Trauma and Acute Care Surgery 80.2, 187-194.
[19] Marasco, S., Davies A., Cooper J., Varma D., Bennett V., Nevill R., Lee G., Bailey M., Fitzgerald M. (2013). "Prospective Randomized Controlled Trial Of Operative Rib Fixation In Traumatic Flail Chest". Journal of the American College of Surgeons 216.5, 924-932.
[20] Al Ali A., Griffin M., Butler P. (2015). “Three-Dimensional Printing Surgical Applications”, ePlasty Open Access Journal of Plastic Surgery, 15. e37, 352-367.
Cite This Article
  • APA Style

    Gordon McCauley, Sanjeet Singh, Sudeep Das De, Alan Kirk. (2017). 3D A Retrospective Cohort Study Examining 3D Reconstruction to 2D Radiology in Identifying Rib Fractures. International Journal of Cardiovascular and Thoracic Surgery, 3(5), 41-52. https://doi.org/10.11648/j.ijcts.20170305.12

    Copy | Download

    ACS Style

    Gordon McCauley; Sanjeet Singh; Sudeep Das De; Alan Kirk. 3D A Retrospective Cohort Study Examining 3D Reconstruction to 2D Radiology in Identifying Rib Fractures. Int. J. Cardiovasc. Thorac. Surg. 2017, 3(5), 41-52. doi: 10.11648/j.ijcts.20170305.12

    Copy | Download

    AMA Style

    Gordon McCauley, Sanjeet Singh, Sudeep Das De, Alan Kirk. 3D A Retrospective Cohort Study Examining 3D Reconstruction to 2D Radiology in Identifying Rib Fractures. Int J Cardiovasc Thorac Surg. 2017;3(5):41-52. doi: 10.11648/j.ijcts.20170305.12

    Copy | Download

  • @article{10.11648/j.ijcts.20170305.12,
      author = {Gordon McCauley and Sanjeet Singh and Sudeep Das De and Alan Kirk},
      title = {3D A Retrospective Cohort Study Examining 3D Reconstruction to 2D Radiology in Identifying Rib Fractures},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {3},
      number = {5},
      pages = {41-52},
      doi = {10.11648/j.ijcts.20170305.12},
      url = {https://doi.org/10.11648/j.ijcts.20170305.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20170305.12},
      abstract = {Introduction: Rib fractures are common presentations at emergency departments across the UK. 21% of emergency admissions are related to rib fractures, resulting from up to 39% of all blunt-trauma to the chest. Imaging is essential for identification of rib fractures but also for planning potential surgical intervention. The introduction of 3D imaging has enhanced the pre-surgical planning in many fields of medicine. We compared 3D CT in the identification of rib fractures to conventional 2D radiology. Methods: A retrospective cohort study of 22 patients was conducted at a district general hospital between Novembers 2014-2016. Chest X-ray, 2D CT and 3D CT findings were compared for the number of rib fractures and identification of displacement of rib fractures. Statistical analysis was performed using a 3-way ANOVA, with Cohen’s kappa statistic (κ) to identify agreement. There were 22 patients (20M: 2F) patients in this study. The mean age of patients was 50.2 ±21.7 (range 10-94). Chest X-rays had the poorest identification rate with slight agreement with 3D CT (κ=0.018). There was also a slight agreement for identification of displacement between 2D and 3D CT imaging (κ=0.127) Conclusion: Chest X-ray on its own is inferior to 2D and 3D CT. 3D CT adds to the value of 2D imaging as it gives an enhanced view of any possible fracture displacement.},
     year = {2017}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - 3D A Retrospective Cohort Study Examining 3D Reconstruction to 2D Radiology in Identifying Rib Fractures
    AU  - Gordon McCauley
    AU  - Sanjeet Singh
    AU  - Sudeep Das De
    AU  - Alan Kirk
    Y1  - 2017/10/23
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ijcts.20170305.12
    DO  - 10.11648/j.ijcts.20170305.12
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 41
    EP  - 52
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20170305.12
    AB  - Introduction: Rib fractures are common presentations at emergency departments across the UK. 21% of emergency admissions are related to rib fractures, resulting from up to 39% of all blunt-trauma to the chest. Imaging is essential for identification of rib fractures but also for planning potential surgical intervention. The introduction of 3D imaging has enhanced the pre-surgical planning in many fields of medicine. We compared 3D CT in the identification of rib fractures to conventional 2D radiology. Methods: A retrospective cohort study of 22 patients was conducted at a district general hospital between Novembers 2014-2016. Chest X-ray, 2D CT and 3D CT findings were compared for the number of rib fractures and identification of displacement of rib fractures. Statistical analysis was performed using a 3-way ANOVA, with Cohen’s kappa statistic (κ) to identify agreement. There were 22 patients (20M: 2F) patients in this study. The mean age of patients was 50.2 ±21.7 (range 10-94). Chest X-rays had the poorest identification rate with slight agreement with 3D CT (κ=0.018). There was also a slight agreement for identification of displacement between 2D and 3D CT imaging (κ=0.127) Conclusion: Chest X-ray on its own is inferior to 2D and 3D CT. 3D CT adds to the value of 2D imaging as it gives an enhanced view of any possible fracture displacement.
    VL  - 3
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom

  • Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom

  • Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom

  • Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, United Kingdom

  • Sections