Computed axial tomography in musculoskeletal trauma.

In the evaluation of patients with musculoskeletal trauma routine X-ray studies are often limited by difficulty in delineating overlapping structures and tissues of similar density. Computerized axial tomography (CT) has proven to be of great value in many diagnostic situations in orthopaedic surgery, particularly in the evaluation of mass lesions. This new technique resolves many of the problems of standard X-rays. It is noninvasive, and can be safely employed in the evaluation of critically ill patients. To assess the usefulness of this technique to trauma, computerized axial tomography has been employed in the diagnosis of injuries of the spine and acetabulum. CT studies of 26 patients with spinal injuries demonstrated accurate localization of displaced bone fragments and other elements of fracture anatomy, obviating the need for myelography. CT scanning of 28 fractures of the acetabulum defined intra-articular fragments and precise details of fracture lines. The additional data provided by CT scanning in these patients was a major asset in the management of their injuries. It influenced the decisions in regard to the need for surgery, and when surgery was indicated, the data helped to define the most appropriate operative approach. Use of the CT did not delay therapy or cause any complications. This experience with spinal injuries and fractures of the acetabulum indicates that computerized axial tomography is a valuable adjunct to the management of musculoskeletal trauma.