Review of Lodox Statscan in the detection of peripheral skeletal fractures in multiple injury patients

Deyle, S.; Brehmer, T.; Evangelopoulos, D.S.; Krause, F.; Benneker, L.M.; Zimmermann, H.; Exadaktylos, A.K.

doi:10.1016/j.injury.2010.03.021

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Volume 41, Issue 8 , Pages 818-822, August 2010

Review of Lodox Statscan in the detection of peripheral skeletal fractures in multiple injury patients

S. Deyle
- Department of Emergency Medicine, University Hospital Bern, Switzerland
T. Brehmer
- Department of Emergency Medicine, University Hospital Bern, Switzerland
D.S. Evangelopoulos
- Department of Emergency Medicine, University Hospital Bern, Switzerland
- Department for Orthopaedic Surgery, University Hospital Bern, Switzerland
- Corresponding author at: Department of Emergency Medicine, University of Bern, Inselspital, Freiburgstrasse 63, 3008 Bern, Switzerland. Tel.: +41 762722623.
F. Krause
- Department for Orthopaedic Surgery, University Hospital Bern, Switzerland
L.M. Benneker
- Department of Emergency Medicine, University Hospital Bern, Switzerland
- Department for Orthopaedic Surgery, University Hospital Bern, Switzerland
H. Zimmermann
- Department of Emergency Medicine, University Hospital Bern, Switzerland
A.K. Exadaktylos
- Department of Emergency Medicine, University Hospital Bern, Switzerland

Accepted 18 March 2010.

Abstract

Introduction

As part of the primary survey, polytrauma patients in our emergency department are examined using the new ‘Lodox Statscan’ (LS) digital low-radiation imaging device. The LS provides full-body anterior and lateral views based on enhanced linear slot-scanning technology, in accordance with the recommended Advanced Trauma Life Support (ATLS) Guidelines. This study's objectives were to establish whether LS appropriately rules out peripheral bone injuries and to examine whether LS imaging provides adequate information for the preoperative planning of such lesions.

Methods

A total of 245 consecutive polytrauma patients aged 16 years or more undergoing LS imaging were included in this retrospective chart analysis. The results of the LS scans were reviewed and compared to additional plain radiographs or computed tomography scans, whenever further radiological imaging was required to determine consecutive therapy.

Results

The sensitivity and specificity of the LS scans were 73% and 100%, respectively, for peripheral skeletal injuries. Additional plain radiographs were performed in 50% of cases for (1) superior focussing and more precise resolution of the affected part of the body, (2) additional second or third plane, (3) additional information about fracture type and planning of the surgical approach and (4) for preoperative planning of implant size and positioning on calibrated digitised films, <1% because of the low quality of the LS scan and <1% because the fracture zone had not been fully captured.

Conclusion

The study demonstrates that despite LS's high sensitivity and specificity in the detection of peripheral skeletal injuries, additional radiological imaging for diagnostic or preoperative reasons was required. Our results imply that LS, although efficient for patient screening in the emergency room, cannot always rule out peripheral skeletal injuries.

Keywords: Lodox, Peripheral skeletal injuries, Full-body scan