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Postoperative Computed Tomography for Articular Fractures: A Systematic Review.

Abstract：

OBJECTIVES:To determine the current published patterns of computed tomography (CT) use postoperatively in peri-articular fractures and identify those populations whereby postoperative CT changes management or results in better clinical outcomes. DATA SOURCES:Systematic review of MEDLINE and Cochrane using a combination of key words, including fracture fixation, fracture healing, and computed tomography. The final update search was performed on May 20, 2015. The search was limited to English language publications of human studies from the past 20 years. STUDY SELECTION:Eligible studies enrolled internally fixed peri-articular fractures in adults imaged routinely with postoperative CT. Facial and spinal fracture studies were excluded. DATA EXTRACTION:One thousand five hundred thirty-seven articles were identified using the search strategy. One thousand two hundred ninty-seven articles were excluded by title. One hundred eighty-three studies were excluded by abstract. Fifty-seven full text articles were assessed for eligibility, 31 studies were eligible for study inclusion. DATA SYNTHESIS:There was no intention to perform combined statistical analysis in the form of a meta-analysis as disparity was anticipated between study populations, interventions, and outcome measures. Routine CT use postoperatively in peri-articular fractures is limited to countries within the developed world, predominantly imaging the lower limb. Only 5 studies detailed postoperative CT leading to a change in patient management; within this pool, only 8 of the 361 individual patients received management changes due to CT scan findings. CONCLUSIONS:Use of postoperative CT in peri-articular fracture fixation has been demonstrated with minimal evidence, this leads to improved clinical outcomes. Based on available literature, postoperative CT scan use is questionable without convincing evidence of benefit. More research is required to identify selected patients who benefit from postoperative CT imaging. LEVEL OF EVIDENCE:Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

journal_title

Journal of orthopaedic trauma

authors

Stott S,Balogh ZJ

doi

10.1097/BOT.0000000000000660

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

56-61

issue

eissn

0890-5339

issn

1531-2291

pii

00005131-201701000-00009

journal_volume

pub_type

杂志文章,meta分析,多中心研究

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Postoperative Computed Tomography for Articular Fractures: A Systematic Review.