The goal of this study is to compare the accuracy of using X-ray, 2D-CT, 3D-CT, and physical modeling in classification of fractures about the elbow as a means of evaluating their relative utility in preoperative workup and treatment planning of fractures.

Ten patients with fractures about the elbow that required operative fixation underwent preoperative X-ray, 2D-CT, 3D-CT, and physical modeling of their injury. Ten orthopaedic physicians classified each injury using each of those four modalities. The answers given by the 10 physicians were compared to an established correct classification for each case, and that data was used to compare the relative accuracy of each modality.

The average accuracy for the given modalities was 62% for X-ray, 76% for 2D-CT, 80% for 3D-CT, and 88% for physical modeling. ANOVA analysis across all modalities revealed findings are statistically significant; however, when compared side by side, only moving from X-ray to 2D-CT yielded significant results.

There was greater percentage correct classification achieved using the more advanced modalities, which therefore may theoretically result in more accurate preoperative planning. However, one must view this finding within the context and limits of this study, which is restricted by the relatively small sample size. Future study into methods of fracture characterization should be done to further evaluate findings such as these, with the goal of promoting better patient outcomes.