Does the Radiographic Lateral View of the Lesser Toe Matter in a Trauma? A Retrospective Analyses of 378 Radiographs

Abstract

Category: Trauma; Lesser Toes Introduction/Purpose: Evaluate the importance of a radiographic lateral view in diagnosing lesser toes traumatic conditions. Methods: Between January 2018 and March 2018, 378 radiographs of 126 patients evaluated in an emergency care hospital for trauma in the lesser toe were retrospectively evaluated for presence of lesser toes traumatic conditions. Patients were selected if a complete series of radiographs were performed, anteroposterior (AP), lateral (LA) and Oblique (OB). Radiographs of the same patient were duplicated and divided in two groups: standard group (AP and OB) and complete group (AP + LA + OB). Images were examined by four independent examiners with different degrees of experience. Each examiner randomly evaluated the same patient twice (one for each group). Kappa index was used to evaluate intra and inter-examiner concordance, and the two- proportion equality test was used to calculate statistical significance. Results: Mean age of patients was 37,2 years (4-85yr), 144 injuries were diagnosed in standard group (28,6%) and 266 injuries (52,8%) in complete group (p<0,001). Individually, each examiner had an improvement in the number of lesions diagnosed when comparing group assessment (p<0,001). Kappa index was superior to 0,60 for all examiners in standard group. Conclusion: Addition of true lateral view was able to detect misdiagnosed injuries in lesser toes trauma and improved the number of diagnosed lesions in 84,6%.