The analysis of X-ray missed diagnosis in ankle fractures by spiral CT 3D reconstruction

Objective To improve the accuracy of diagnosis of ankle fractures by analyzing the cause of X-ray missed diagnosis in the ankle fractures using spiral CT 3D reconstruction. Methods The results of ankle fracture X-ray radiographs and spiral CT 3D reconstruction of 80 cases from January 2010 to February 2013 were compared, the causes of X-ray misdiagnosis were analyzed. Results X-ray in conformity with spiral CT 3D reconstruction diagnosis were found in 66 cases(82.5%),with 14 cases missed(17.5%).In these missed cases, there were 5 cases of posterior malleolus fractures,1 case of medial malleolus fractures, 3 cases of foot bone fracture (1 case of Talus Fractures,1 case ofcuboid and calcaneus case, 1case of metatarsal case), 4 cases of fracture complicated with subluxation(2 case of lateral shift of the talus, 2 case of Inferior tibiofibular syndesmosis separation),1 case of intra articular free bone fragments. Conclusion Multiple ankle fractures, especially posterior malleolus fractures, foot bone fractures, fracture complicated with subluxation and intra articular free bone fragments are easy to misdiagnosis on X-ray films. Careful observation of the edge of ankle, specifically posterior cortical bone of tibia and articular surface continuous, joint space widening and using spiral CT to scan complex injury timely can reduce the misdiagnosis of spiral CT scans.