BACKGROUND: This study was performed to investigate the relationship between coronal computed tomography (CT) and Broden's view in terms of location of the fracture line and fracture pattern. METHODS: Forty-five feet of 45 patients with intraarticular calcaneal fractures were evaluated. The mean age of the patients was 46.3 years (standard deviation, 18.1; range, 15 to 80 years), and there were 34 men and 11 women. The Broden's views were acquired using the ray sum projection, reviewed, and correlated with the coronal CT image to determine the location of the fracture on the posterior facet and fracture pattern described by the Sanders classification. The quantified location of the fracture line was defined as the distance between the medial margin of posterior facet and the fracture line divided by the whole length of the posterior facet, which was expressed as a percentage. RESULTS: The fracture line on the Broden's view was positioned at 22.3% (standard deviation, 29.6) laterally compared to that on coronal CT (p < 0.01). Although all cases showed posterior facet involvement on the CT scan, the fracture line was positioned lateral to the posterior facet in 6 cases (13.3%) in the Broden's view. The coronal CT and Broden's view showed a low level of agreement in the fracture pattern according to the Sanders classification, with kappa values of 0.23. CONCLUSIONS: Surgeons should consider that the fracture line on the Broden's view shows positioning laterally compared to coronal CT and they should consider that the fracture line at the lateral to posterior facet on the Broden's view might be an intraarticular fracture line. There are some limitations when applying the Sanders classification with the Broden's view.
Adolescent ; Adult ; Aged, 80 and over ; Calcaneus/*injuries/*radiography ; Female ; Foot Injuries/*radiography ; Fractures, Bone/*radiography ; Humans ; Intra-Articular Fractures/*radiography ; Male ; Middle Aged ; Patient Positioning/*methods ; Retrospective Studies ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods

OBJECTIVE: To assess the feasibility of visualizing hand and foot tendon anatomy and disorders by Gemstone Spectral Imaging (GSI) high-definition CT (HDCT). MATERIALS AND METHODS: Thirty-five patients who suffered from hand or foot pain were scanned with GSI mode HDCT and MRI. Spectrum analysis was used to select the monochromatic images that provide the optimal contrast-to-noise ratio (CNR) for tendons. The image quality at the best selected monochromatic level and the conventional polychromatic images were compared. Tendon anatomy and disease were also analyzed at GSI and MRI. RESULTS: The monochromatic images at about 65 keV (mean 65.09 +/- 2.98) provided the optimal CNR for hand and foot tendons. The image quality at the optimal selected monochromatic level was superior to conventional polychromatic images (p = 0.005, p < 0.05). GSI was useful in visualizing hand and foot tendon anatomy and disorders. There were no statistical differences between GSI and MRI with regard to tendon thickening (chi2 = 0, p > 0.05), compression (chi2 = 0.5, p > 0.05), absence (chi2 = 0, p > 0.05) and rupture (chi2 = 0, p > 0.05). GSI was significantly less sensitive than MRI in displaying tendon adhesion (chi2 = 4.17, p < 0.05), degeneration (chi2 = 4.17, p < 0.05), and tendinous sheath disease (chi2 = 10.08, p < 0.05). CONCLUSION: GSI with monochromatic images at 65 keV displays clearly the most hand and foot tendon anatomy and disorders with image quality improved, as compared with conventional polychromatic images. It may be used solely or combined with MRI in clinical work, depending on individual patient disease condition.
Adolescent ; Adult ; Female ; Foot/pathology/*radiography ; Hand/pathology/*radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Musculoskeletal Diseases/diagnosis/radiography ; *Radiographic Image Enhancement ; Tendon Injuries/diagnosis/*radiography ; Tendons/pathology/*radiography ; Tomography, X-Ray Computed/*methods ; Young Adult

College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 +/- 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development were the right 5th toe (61%) and the left 5th toe (57%). The little toes seem to have been subjected to the greatest friction and shearing forces. March-related injuries, excluding foot injuries, were ankle pain (12.7%), knee pain (12.7%) and Achilles tendon pain (7.7%). Six subjects (4.2%) needed extra medical treatment for more than 2 weeks prior to returning to their daily lives after completion of the march due to associated injuries. The present study observed a very high incidence rate of injuries (95.1%) associated with the 580 km university students grand road march. These injuries posed an obstacle against completion of the road march and against returning to daily life. Active preventive interventions such as physical therapy and customized reinforced shoes and education program are recommended for reducing incidence rate and severity of injuries.
Adult ; Blister/complications/*epidemiology ; Body Mass Index ; Female ; Foot Injuries/complications/*epidemiology ; Humans ; Incidence ; Male ; Pain/epidemiology/etiology ; Questionnaires ; Spine/radiography ; Students ; Time Factors ; Universities ; *Walking ; Young Adult

Adult ; Bone and Bones ; diagnostic imaging ; injuries ; Femoral Fractures ; surgery ; therapy ; Foot Deformities, Acquired ; diagnosis ; etiology ; therapy ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Fractures, Ununited ; diagnostic imaging ; etiology ; surgery ; Humans ; Intra-Articular Fractures ; diagnostic imaging ; surgery ; Male ; Radiography ; methods ; Reoperation ; methods ; Treatment Outcome