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KMID : 1151820130070020107
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Journal of the Korean Society of Radiology
2013 Volume.7 No. 2 p.107 ~ p.112
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Broden photographing method for Calcaneus Subtentaculum tali observation of Ankle plaster patient
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Ahn Byeoung-Ju
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Abstract
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There is an Ankle Oblique(Broden’ low) as an examination for the patient whose ankle was encased in orthopedic plaster. Some types of Ankle Joint coalition - Calcaneonavicular coalition, Talocalcaneal coalition and Naviculocuneiform coalition. This study is focused on the relation between Ankle Joints and the structural change of soft tissues, also finding the most proper angle to obtain good images of Ankle Joint from the patient who wore a plaster on his ankle, when we x-ray with Harris-Beath View(30°∼55°) - for observing Subtalar joint, Calcaneus Fracture, Subtentaculum, Tali Fracture and Talocalcaneal coalition. We intend to get the angle which makes us achieve the good image that shows Calcaneus Fracture, Subtentaculum, and Tali Fracture by changing internal angles of the patient’s ankle. We evaluated the images obtained from 51 patients with PACS monitor. The result of the evaluation, subtalar joint was not seperated but opened, and Subtentaculum Tali Fracture was seen overlaid. at the angle 30, we could observe Calcaneus Fracture, Subtentaculum Tali Frature and the front part of behind side of subtalar joint well. And Calcaneo Navicularcoalition, Talocal Canealcoalition, Naviculo Cuneiform coalition condition were clearly seen at that angle. At the angle 35, we could achieve the clear images of subtalar comminuted fracture, talus, the behind joint of heel bone and get the high definition image on the degree of talocalcaneal joint separation. In addition to, We could obtain the good wide image of Sinus Tarsi. At the area of 45, We can distinguish the soft tissues from gyps separation. The outer-talus and density of the bone were definitely seen and Calcaneus is more separated than that of at the angle of 35, but this image is distorted. Calcaneus, Subtentaculum Tali show 1.20±0.414 at the angle 25, 2.47±0.516 at the angle 30, 2.27±0.458 at the angle 45. This difference is statistically meaningful. (p<0.05). Including the degree of distortion, The distortion appears less at the area of 30° but at the area of 40, there is heavy distortion. So, We could get the best image for making a diagnosis. At the 30∼35° degree for X-raying ankle. and at the 30∼40° for Calcaneus Fracture, Subtentaculum Tali Fracture.
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KEYWORD
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Ankle Joint cast photography, X-ray angle and patients potion, Calcaneus Fracture, Subtentaculum Tali Frature, Calcaneus Fracture
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