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Alignment in total ankle replacement is important for success and implant survival. Recently there has been the introduction and adoption of patient specific instrumentation for implantation in total ankle replacement. Current literature does not evaluate the effect of preoperative deformity on accuracy of patient specific instrumentation. A retrospective radiographic analysis was performed on 97 consecutive patients receiving total ankle replacement with patient specific instrumentation to assess the accuracy and reproducibility of the instrumentation. Subgroup analysis evaluated the effect of preoperative deformity. All surgeries were performed by fellowship trained foot and ankle surgeons without industry ties to the implants used. Preoperative and postoperative films were compared to plans based on computerized tomography scans to assess how closely the plan would be implemented in patients. Overall postoperative coronal plane alignment was within 2° of predicted in 87.6% (85 patients). Similarly, overall postoperative sagittal plane alignment was within 2° of predicted in 88.7% (86 patients). Tibial implant size was accurately predicted in 81.4% (79 patients), and talus implant size was correct in 75.3% (73 patients). Patients with preoperative varus deformity had a higher difference between predicted and actual postoperative alignment compared to valgus deformity (1.1° compared to 0.3°, p =.02). A higher average procedure time was found in varus patients, and more adjunctive procedures were needed in patients with varus or valgus deformity, but these were not significant, p >.5. Surgeons can expect a high degree of accuracy when using patient specific instrumentation overall, but less accurate in varus deformity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Distal tibial tuberosity-high tibial osteotomy is a surgical treatment for knee osteoarthritis, but there is still a lack of clinical studies on its effect on ankle joints. OBJECTIVE: To observe the effects of distal tibial tuberosity-high tibial osteotomy on ankle angle on coronal plane of the radiography of the full length of lower limb in weight loading. METHODS: Data of 40 patients (41 knees) with distal tibial tuberosity-high tibial osteotomy from March 2021 to March 2022 were retrospectively analyzed, including 31 females and 9 males, 20 left knees and 21 right knees, aged 49-75 years, mean (63.44±6.57) years. The radiographic data of the full length of the lower limb in weight loading were collected before, week 2 and week 48 postoperatively. Hip-knee-ankle angle, talar tilt angle, tilt angle of the ankle, tibiocrural angle, and tibial articular surface angle were measured before and after surgery. RESULTS AND CONCLUSION: (1) Hip-knee-ankle angle improved from (-6.24±3.69)° before operation to (2.59±3.49)° week 2 postoperatively and (2.15±3.49)° week 48 postoperatively. The tilt angle of the ankle changed from (-7.90±3.11)° before operation to (-2.51±2.59)° week 2 postoperatively and (-2.46±2.42)° week 48 postoperatively, with statistically significant difference (P < 0.001). (2) There was no significant difference in talar tilt angle, tibiocrural angle, and tibial articular surface angle before and week 2 postoperatively. (3) No significant difference in the angle changes was detected between week 2 and week 48 postoperatively. (4) It is indicated that distal tibial tuberosity-high tibial osteotomy can not only correct genu varus but also improve ankle angle. This result remains stable after 48 weeks of weight-bearing activities. [ABSTRACT FROM AUTHOR]

Objective: To compare the coronal plane with axial and sagittal planes in opportunistic screening of osteoporosis using computed tomography (CT). Materials and methods: A total of 100 patients aged ≥ 50 years who underwent both lumbar spine CT and dual-energy X-ray absorptiometry within 3 months were included. Osteoporosis was diagnosed based on dual-energy X-ray absorptiometry results. The CT number was measured at the center of the vertebral body in coronal, axial, and sagittal planes. To compare the coronal plane with axial and sagittal planes in diagnosing osteoporosis, the areas under the receiver operating characteristic curve (AUC) were compared and intraclass correlation coefficient (ICC) was calculated. The optimal cutoff values were calculated using Youden's index. Results: The AUC of the coronal plane (0.80; 95% confidence interval [CI], 0.71–0.89) was not significantly different from that of the axial plane (0.78; 95% CI, 0.68–0.87; P = 0.39) and that of the sagittal plane (0.78; 95% CI, 0.69–0.87; P = 0.68). Excellent concordance rates were observed between coronal and axial planes with ICC of 0.95 (95% CI, 0.92–0.96) and between coronal and sagittal planes with ICC of 0.93 (95% CI, 0.85–0.96). The optimal cutoff values for the coronal, axial, and sagittal planes were 110, 112, and 112 HU, respectively. Conclusion: The coronal plane does not significantly differ from axial and sagittal planes in opportunistic screening of osteoporosis. Thus, the coronal plane as well as axial and sagittal planes can be used interchangeably in measuring bone mineral density using CT. [ABSTRACT FROM AUTHOR]

Objectives: The coronal plane is the unique display mode of automated breast (AB) ultrasound (US), which has valuable features of showing the entire breast anatomy and providing additional diagnostic value for breast lesions. However, whether adding the coronal plane could improve the diagnostic performance in screening breast cancer remains uncertain. This study aimed to evaluate the value of adding the coronal plane in interpretation for AB US screening. Methods: In this retrospective study, AB US images from 644 women (396 in the no‐finding group, 143 with benign lesions, and 105 with malignant lesions) aged 40–70 years were collected between January 2016 and October 2020. Four novice radiologists (with 1–5 years of experience with breast US) and four experienced radiologists (with >5 years of experience with breast US) were assigned to read all AB US images in the transverse plane plus coronal plane (T + C planes) and transverse plane (T plane) alone in separate reading sessions. Diagnostic performance, lesion conspicuity, and reading time were compared using analysis of variance. Results: The mean reading time of all radiologists was significantly shorter in the T + C planes reading mode than in the T plane alone (115 ± 32 vs 128 ± 31 s, respectively; P <.05), and cancers had a higher conspicuity (odds ratio, 1.76; 95% confidence interval [CI], 1.00–3.08; P =.04). No significant differences were noted in the two reading modes (T + C planes vs T plane) in the sensitivity (82% [95% CI, 74–89%] vs 81% [95% CI, 74–88%], respectively; P =.68) and specificity (68% [95% CI, 62–75%] vs 70% [95% CI, 64–75%], respectively; P =.39) when Breast Imaging‐Reporting and Data System (BI‐RADS) 3 was set as the threshold. There were also no significant differences in the two reading modes (T + C planes vs T plane) in the sensitivity (70% [95% CI, 64–76%] vs 69% [95% CI, 63–75%], respectively; P =.39) and specificity (91% [95% CI, 87–96%] vs 91% [95% CI, 88–95%], respectively; P =.90) when BI‐RADS 4 was set as the threshold. In addition, the mean areas under the receiver operating characteristic curves of all radiologists in the two reading modes (T + C planes vs T plane) were not significantly different (0.84 [95% CI, 0.79–0.89] vs 0.83 [95% CI, 0.78–0.89], respectively; P =.61). Conclusions: Adding a coronal plane in the AB US screening setting saved the reading time and improved the conspicuity of breast cancers but not the diagnostic performance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the ratio of sagittal length to coronal length of the distal tibia for predicting the sagittal length of the distal tibia. A total of 202 ankles were measured based on CT imaging availability. We measured the coronal length (Width, W) parallel to the Chaput tubercle from CT scans. Sagittal length was divided into 3 points (Diameter D1, D2, D3) in the axial plane on the same level. The relationship between coronal length and each sagittal length was determined through correlation analysis. A prediction model was then developed using multiple regression. We also analyzed the quality of the prediction model and validated the prediction model with a validation cohort. Each sagittal length (D1, D2, D3) and coronal length had a significant positive correlation (p <.01). In the prediction model, sex, height, and W were significantly associated with D1, D2, and D3 (p <.05). Prediction models were made for each sagittal length (D1, D2, D3). Concordance correlation coefficient (CCC) values of prediction models for D1, D2, and D3 were 0.78, 0.72, and 0.72 for the derivation cohort and 0.69, 0.63, and 0.61 for the validation cohort, respectively. Accuracies of models as ± 2SD for D1, D2, and D3 were 93.9%, 94.9%, and 94.9%, respectively. This study predicted the sagittal length of the distal tibia for preoperative planning by measuring the coronal length of the distal tibia. Prediction of the sagittal length of the distal tibia can help foot and ankle surgeons fixate screws stably to prevent iatrogenic injury of posterior structures of the distal tibia. [ABSTRACT FROM AUTHOR]

Endoscopic transnasal approaches (ETAs) to the ventrolateral skull base are commonly classified according to coronal planes or anatomical structures. Our goal is to simplify the description of the ETA to lateral skull base regions in a sequential dissection with correlation to computed tomography, helping in preoperative planning and efficient surgical exposure, and exposing the surgical anatomy limitations. Five freshly injected cadaver heads were dissected using an extended ETA to the lateral skull base. Each specimen underwent a high-resolution computed tomography scan. A classification of the lateral skull base based on well-defined zones was proposed. We divided the lateral target into four different zones, in a craniocaudal orientation: zone 1 is the space lying between the orbital floor superior and the level of the sellar floor inferior, zone 2 is on the coronal plane, located between the level of the sellar floor and the vidian canal, zone 3 is the area lateral to the anterior limb of the petro-occipital fissure, located between the vidian canal and the carotid canal, and zone 4 is the space located between the carotid canal and the extracranial opening of the hypoglossal canal, lateral to the anterior part of the posterior limb of petro-occipital fissure. Multiple previous works have described and classified the coronal plane and its lateral extensions. Our classification system for the proposed lateral zones enables preoperative planning to select a suitable approach. The craniocaudal orientation facilitates the understanding of surgical corridors and tailored exposure. [ABSTRACT FROM AUTHOR]

Total ankle replacements have become increasingly popular, providing a viable alternative to ankle arthrodesis in patients with end stage ankle arthritis. Continued advancements in implant design have substantially improved long term survival outcomes as well as patient pain relief, range of motion, and quality of life. Surgeons continue to advance the indications for implantation of total ankle replacements in patients with more severe varus and valgus coronal plane deformity. This report of twelve cases demonstrates our algorithmic approach to total ankle arthroplasty in patients with deformity of the foot and ankle. By proposing a clinical algorithm with case examples, we aim to aid clinicians in successfully approaching coronal plane deformities of the foot and ankle when using total ankle replacement to ultimately improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Abstract Background Existing approaches for treating elbow fractures include lateral, medial, anterior and posterior approaches, though the anterior approach is often not chosen by surgeons to avoid damage to important nerves and blood vessels. However, the anterior approach has unique advantages. The purpose of this study was to report outcomes of 38 patients with coronal plane elbow fractures treated through the anterior approach. Methods We retrospectively analyzed 38 cases of coronal plane elbow fracture treated through an anterior approach at our institution between March 2015 and July 2019. The length of the surgical incision, operation time, and postoperative complications were recorded. The range of flexion, extension, and rotation of the affected elbow and the healthy elbow were collected at follow-up. Functional outcomes were evaluated using the Mayo Elbow Function Score (MEPS). Results All 38 patients were followed up for a mean of 21.26 months (range 12–36 months). Intraoperatively, the mean surgical incision length was 8 ± 2 cm and the mean operative time was 123 ± 59 min. At the final follow-up, solid osseous union was confirmed for all coronal plane elbow fractures. The mean elbow flexion arc was 129 ± 7°, and the extension arc was 9 ± 6°. The mean pronation arc was 83 ± 3°, and the supination arc was 80 ± 3°. The mean MEPS was 90 ± 8 points, with 18 excellent cases and 20 cases of excellent and good results, respectively. In 31 cases, there was no significant difference in elbow extension, flexion, or pronation between the single-fracture and healthy elbows (P > 0.05), though the arc of supination was slightly worse than that of the healthy elbow (P

BACKGROUND: The motion of the knee joint is a three-dimensional motion with three translational degrees of freedom and three rotational degrees of freedom. When the prosthesis is implanted in total knee arthroplasty, the varus angle of the coronal plane, the anteroposterior angle of the sagittal plane and the rotation angle of the axial plane should be fully considered. OBJECTIVE: To summarize the clinical advantages and disadvantages of femoral and tibial prosthesis implantation angle in total knee arthroplasty, so as to provide reference for effective prosthesis implantation in total knee arthroplasty. METHODS: The first author searched the literature on prosthesis implantation in PubMed database and CNKI database by computer. The English key words were “total knee arthroplasty, total knee replacement, femoral, tibial, coronal, sagittal, axial, prosthesis, component, alignment, osteotomy”. The Chinese key words were “total knee arthroplasty, femur, tibia, prosthesis, osteotomy, coronal, sagittal, axial, alignment”. The articles that meet the search terms are preliminarily screened, and the relevant articles related to the review content and the clinical advantages and disadvantages of prosthesis implantation are retained for further detailed analysis, induction and summary. RESULTS AND CONCLUSION: (1) On the coronal plane of the femur, the angle between the mechanical axis of the lower limb and the anatomical axis of the femur is measured through the full-length film of the weight-bearing position of the lower limb as a reference for femoral osteotomy. The 4-6° valgus osteotomy is often taken, and the prosthesis is implanted perpendicular to the mechanical axis. (2) In the sagittal plane of the femur, to obtain good knee flexion function, the 0-3°anteversion osteotomy is often taken and the prosthesis is implanted slightly anteversion. (3) In the axial plane of the femur, although surgical transepicondylar axis is regarded as the rotation center of the distal femur, it is more convenient to refer to posterior condylar axis when using surgical instruments, and the prosthesis is rotated 2-5° outward relative to posterior condylar axis. (4) In the coronal plane of the tibia, to obtain the rectangular space and horizontal joint line in the extended position, the prosthesis should be implanted perpendicular to the mechanical axis of the tibia. (5) In the sagittal plane of the tibia, the polyethylene gasket has a certain retroversion angle, and the prosthesis is often implanted with a retroversion of 0-7°. (6) In the axial plane of the tibia, because the Akagi line is approximately parallel to the anterior and posterior axis of the tibia, the anterior and posterior axis of the prosthesis is often implanted parallel to the Akagi line. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasound measurements of the aorta are typically taken in the axial plane, with the transducer perpendicular to the aorta, and diameter measurements are obtained by placing the callipers from the anterior to the posterior wall and the transverse right to the left side of the aorta. While the 'conventional' anteroposterior walls in both sagittal and transverse plains may be suitable for aneurysms with less complicated geometry, there is controversy regarding the suitability of this approach for complicated, particularly tortuous aneurysms, as they may offer a more challenging situation. Previous work undertaken within our research group found that when training inexperienced users of ultrasound, they demonstrated more optimal calliper placement to the abdominal aorta when approached from a decubitus window to obtain a coronal image compared to the traditional ultrasound approach. Purpose: To observe the level of agreement in real‐world reporting between computed tomography (CT) and ultrasound measurements in three standard planes; transverse AP, sagittal AP and coronal (left to right) infra‐renal abdominal aortic aneurysm (AAA) diameter. Methodology: This is a retrospective review of the Otago Vascular Diagnostics database for AAA, where ultrasound and CT diameter data, available within 90 days of each other, were compared. In addition to patient demographics, the infrarenal aorta ultrasound diameter measurements in transverse AP and sagittal AP, along with a coronal decubitus image of the aorta was collected. No transverse measurement was performed from the left to the right of the aorta. Results: Three hundred twenty‐five participants (238 males, mean age 76.4 ± 7.5) were included. Mean ultrasound outer to the outer wall, transverse AP and sagittal AP diameters were 48.7 ± 10.5 mm and 48.9 ± 9.9 mm, respectively. The coronal diameter measurement of the aorta from left to right was 53.9 ± 12.8 mm in the left decubitus window. The mean ultrasound max was 54.3 ± 12.6 mm. The mean CT diameter measurement was 55.6 ± 12.7 mm. Correlation between the CT max and ultrasound max was r2 = 0.90, and CT with the coronal measurement r2 = 0.90, CT and AP transverse was r2=0.80, and CT with AP sagittal measurement was r2 = 0.77. Conclusion: The decubitus ultrasound window of the abdominal aorta, with measurement of the coronal plane, is highly correlated and in agreement with CT scanning. This window may offer an alternative approach to measuring the infrarenal abdominal aortic aneurysm and should be considered when performing surveillance of all infra‐renal AAA. [ABSTRACT FROM AUTHOR]

Background: Existing approaches for treating elbow fractures include lateral, medial, anterior and posterior approaches, though the anterior approach is often not chosen by surgeons to avoid damage to important nerves and blood vessels. However, the anterior approach has unique advantages. The purpose of this study was to report outcomes of 38 patients with coronal plane elbow fractures treated through the anterior approach.Methods: We retrospectively analyzed 38 cases of coronal plane elbow fracture treated through an anterior approach at our institution between March 2015 and July 2019. The length of the surgical incision, operation time, and postoperative complications were recorded. The range of flexion, extension, and rotation of the affected elbow and the healthy elbow were collected at follow-up. Functional outcomes were evaluated using the Mayo Elbow Function Score (MEPS).Results: All 38 patients were followed up for a mean of 21.26 months (range 12-36 months). Intraoperatively, the mean surgical incision length was 8 ± 2 cm and the mean operative time was 123 ± 59 min. At the final follow-up, solid osseous union was confirmed for all coronal plane elbow fractures. The mean elbow flexion arc was 129 ± 7°, and the extension arc was 9 ± 6°. The mean pronation arc was 83 ± 3°, and the supination arc was 80 ± 3°. The mean MEPS was 90 ± 8 points, with 18 excellent cases and 20 cases of excellent and good results, respectively. In 31 cases, there was no significant difference in elbow extension, flexion, or pronation between the single-fracture and healthy elbows (P > 0.05), though the arc of supination was slightly worse than that of the healthy elbow (P < 0.05). VAS pain scores before the operation, at three months after the operation, and during follow-up were compared, and pain was significantly reduced after treatment (P < 0.05). Two patients experienced transient postoperative median nerve paralysis, from which they recovered within three months. One patient had mild heterotopic ossification and was not treated because it did not affect the function of the elbow joint. All patients returned to work and were satisfied with the treatment.Conclusion: The anterior approach has the benefits of simplicity, safety, minimal invasiveness, excellent exposure, and satisfactory prognosis for coronal plane elbow fracture. [ABSTRACT FROM AUTHOR]

Thalamic hemorrhage is one of deep-seating cerebral lesions. Conservative therapy is preferred to patients with minor thalamic hemorrhage, and external ventricular drainage is usually applied in patients with cerebral ventricular hemorrhage. However, the prognosis of some patients is poor. This study intends to explore that minimally invasive puncture to remove hematoma in patients with the thalamic hemorrhage volume less than 15 ml with disturbance of consciousness (especially the expansion of the hematoma to the hypothalamus or midbrain) is an alternative method. In clinical practice, a wedge-shaped sign of thalamic hemorrhage could be observed in CT images in coronal plane, which was featured by the compression of hematoma on the third ventricle and the aqueduct of midbrain shaped like a wedge into the mesencephalon. The obstruction of cerebrospinal fluid circulation was then evaluated. For persistent hematoma oppression, the precise positioning of stereotactic instrument could be applied to rapidly and effectively remove the oppression, thus improving life quality of affected patients.

Abstract Introduction The appropriate and optimal treatment for thoracic and lumbar (TL) burst fractures remains a topic of debate. Characterization of vertical laminar fractures (coronal cross-sectional imaging) is presented in this study to determine the severity and treatment options in TL burst fractures. Methods A retrospective evaluation of 341 consecutive patients with TL burst fractures was divided into Group I (whole), Group II (partial), and Group III (intact) based on the vertical laminar fracture morphology from coronal images on computed tomography (CT) scans. The presence of preoperative neurological status was reviewed, and several radiological parameters were measured. In addition, the incidence of dural tears was calculated in patients that underwent a decompression with posterior approach. Results In total, 270 lumbar and 71 thoracic burst fractures were analyzed. Compared with the intact group, the two other groups had significantly shorter central canal distance, wider interpedicular distance, and smaller spinal canal area, in particular, Group III. The incidences of preoperative neurological deficits in Groups I to III were 63.0, 22.2, and 6.3%, respectively. The incidences of dural tears in Groups I to III were 25.6, 6.3, and 0%, respectively. Conclusion The morphology of vertical laminar fractures observed across the coronal plane was important. Patients with “whole”, “partial” and “intact” laminar fractures indicated different severity of TL burst fractures. Due to the high probability of dural tears, decompression is recommended as a primary intervention for patients with “whole” laminar fractures. However, for patients without vertical laminar fractures, minimally invasive technique might be a better choice to avoid approach-related complications.

Spectrum of disease involves nasal passage and paranasal sinuses termed as sinonasal disease. CT is superior to other imaging modalities in the assessment of the paranasal sinuses (PNS) pathology. Functional Endoscopic Sinus Surgery (FESS) is the common modality of treatment for diseases of nose and PNS. Coronal CT images closely correlates with the surgical approach. Therefore, CT is the preferred study before FESS. The lateral lamella of cribriform plate (LLCP) is the thinnest bone in the anterior skull base and most vulnerable parts of the skull base for iatrogenic complication during FESS. Therefore, preoperative evaluation of LLCP is importance in a successful FESS. The study focused on the vertical height of the LLCP and the angulation of LLCP with CP. This study was performed retrospectively on CT images of 600 adult subjects. Chi square test and pearson correlation were used for data analysis. Type II is most prevalent type of Kero's type. There is a significant correlation between Kero's classification and Gera's classification. A positive correlation found between the vertical height of LLCP with its angle formed by CP and the correlation was found to be significant. Assessment on LLCP in its 2 aspect both vertical height of LLCP and its sloping with CP certainly gives a map to the surgeon during FESS and to improve the safety profile of the procedure. [ABSTRACT FROM AUTHOR]

Background: Sagittal balance in severe androgen insensitivity syndrome (AIS) patient has been difficult to study due to problems with imaging technique. Abnormal sagittal profiles have been frequently observed in AIS patients presenting as cervical kyphosis, thoracic hypokyphosis, and positive sagittal vertical axis (SVA) off set. The significance of these changes is not understood in these patients. The purpose of this study is to assess the sagittal profile of AIS patients before and after surgery. Subjects and Methods: Changes in curve correction in both coronal and sagittal planes before and after surgery. Curve type, Cobb angles, sagittal parameters, and fusion level were analyzed with conventional parameters. Patient outcomes were measured using mobile device friendly Scoliosis Research Society-22 questionnaire online. Results: Fourteen patients were recruited. Average age was 16 years (13–36). Postoperation and final follow-up Cobb angles were reduced to 27°, 26°, and 16° and 29°, 28°, and 16°, respectively. In the sagittal plane, the Cobb angles pre- and postoperation and final follow-up are as follows: Cervical lordosis (36.7, 39.1, and 41.9), thoracic kyphosis (33.1, 35.8, and 39.1), lumbar lordosis (51.1, 45.2, and 54.2), SVA (1.3, 1.6, and 0), pelvic tilt (19, 21, and 18), sacral slope (47, 46, and 55), and pelvic tilt (43.7, 45, and 43.5). “Function”, “satisfaction,” and “mean” were significantly improved over the period, particularly between the last seen visit and before surgery. Conclusions: Abnormal coronal and sagittal parameters and their changes after surgery are reported in AIS patients. Patients expressed significant improvements in their function abilities and satisfied with clinical management, as well as their general quality of life.

The ability to navigate the anterior lumbar disc space may improve clinical outcomes and implant longevity. However, no robotic navigation systems are presently authorized by the U.S. Food and Drug Administration to assist with anterior retroperitoneal lumbar interbody surgery. Furthermore, no studies to date have investigated such an application of this technology. This study examines the application of robotic navigation to anterior lumbar total disc replacement surgery to improve retroperitoneal exposure and orientation of the anterior lumbar spine, enhance coronal plane centralization of the implant, optimize surgical trajectory, and mitigate radiologic exposure. Postoperative outcomes of a small cohort of patients undergoing anterior lumbar total disc replacement surgery using robotic navigation were analyzed. The results of the study revealed that a modified use of the aforementioned robot-assisted surgical technology enhances coronal plane centralization and trajectory, all while mitigating radiologic exposure, resulting in more accurate placement of the implant within the intervertebral space at each level.

Introduction: The treatment of intercondylar distal femur fractures requires anatomic reduction of intra-articular fragments and absolute fixation. Preoperative planning is necessary to understand fracture morphology. All fracture lines need to be recognized as the primary implant may not capture all articular fragments, mainly when coronal plane fractures are present. Oftentimes, independent interfragmentary compression screws are necessary. No recent studies have visually mapped out the distal femur articular fracture fragments necessary for absolute fixation. The objectives of this study are to determine the frequency of coronal plane fractures in intercondylar distal femur fractures and describe the pattern of intra-articular fracture fragments.Materials and Methods: The hospital's trauma registry was queried for distal femur ORIF CPT codes logged in the past four years. A retrospective chart review was performed using the EMR and CT scans. Demographics and mechanisms of injury were analyzed. Fracture fragments were surveyed and drawn out by hand on a template for easy organization. Patients' fractures were categorized into the following groups: fractures with no intra-articular coronal plane fractures, those with medial coronal fractures, those with lateral coronal fractures, or those with both medial and lateral coronal fractures. Major fracture fragments were identified.Results: A total of 55 patients were included. 26 patients (47%) were found to have no intra-articular coronal plane fractures; 6 patients (11%) were found to have medial coronal plane fractures; 15 patients (27%) were found to have lateral coronal plane fractures, and 8 patients (15%) had medial and lateral coronal plane fractures. Collectively, intra-articular coronal plane fractures were identified in 29 patients (53%) with intercondylar distal femur fractures. Four major fracture fragments along with intercondylar and condylar comminution sites were identified.Discussion: Distal femur intra-articular coronal plane fractures can yield large anterior and posterior condylar fracture fragments of either the medial condyle, lateral condyle, or both condyles. Coronal plane fracture fragments must be identified to obtain absolute fixation. Our study found a higher coronal plane fracture line frequency (52.7%) than prior commonly cited studies. Surgeons must be on the lookout for anterior fracture fragments, posterior fracture fragments, and articular comminution when treating intercondylar femur fractures. [ABSTRACT FROM AUTHOR]

Introduction: The appropriate and optimal treatment for thoracic and lumbar (TL) burst fractures remains a topic of debate. Characterization of vertical laminar fractures (coronal cross-sectional imaging) is presented in this study to determine the severity and treatment options in TL burst fractures.Methods: A retrospective evaluation of 341 consecutive patients with TL burst fractures was divided into Group I (whole), Group II (partial), and Group III (intact) based on the vertical laminar fracture morphology from coronal images on computed tomography (CT) scans. The presence of preoperative neurological status was reviewed, and several radiological parameters were measured. In addition, the incidence of dural tears was calculated in patients that underwent a decompression with posterior approach.Results: In total, 270 lumbar and 71 thoracic burst fractures were analyzed. Compared with the intact group, the two other groups had significantly shorter central canal distance, wider interpedicular distance, and smaller spinal canal area, in particular, Group III. The incidences of preoperative neurological deficits in Groups I to III were 63.0, 22.2, and 6.3%, respectively. The incidences of dural tears in Groups I to III were 25.6, 6.3, and 0%, respectively.Conclusion: The morphology of vertical laminar fractures observed across the coronal plane was important. Patients with "whole", "partial" and "intact" laminar fractures indicated different severity of TL burst fractures. Due to the high probability of dural tears, decompression is recommended as a primary intervention for patients with "whole" laminar fractures. However, for patients without vertical laminar fractures, minimally invasive technique might be a better choice to avoid approach-related complications. [ABSTRACT FROM AUTHOR]

Background: The fractures of the odontoid process constitute 10% of all cervical spine injuries. Odontoid screw placement, although technically challenging, in indicated cases is the ideal treatment. Hence, a thorough knowledge of the odontoid dimensions is necessary prior to the surgical endeavor, more so for planning double odontoid screws.Materials and Methods: A prospective morphometric analysis of retrospective data of 250 patients was acquired at our institute using Somatom Definition edge 128 slice 64-row detector Siemens CT scanner. The dimensions of the odontoid process were measured at the waist (narrowest portion), widest diameter both in anteroposterior and transverse diameters. The dimensions of the C2 vertebra were measured at the level of the superior and inferior endplate in both the planes.Results: A total of 250 patients were evaluated with age ranging from 1 to 80 years. Males constituted 174 (69.6%) and 76 (30.4%) were females. The mean transverse diameter (TD) at the odontoid waist (narrowest diameter) was 8.66 mm. The mean TD at the widest point of odontoid was 9.68 mm. Mean anteroposterior (AP) diameter 2.5 mm away from the midline on the left side at the level of the waist was 9.51 mm and 2.5 mm on the right of midline was 9.01 mm. The mean AP diameter at the C2 base was 15.824 mm in males and 14.833 mm in females (P < 0.001).Conclusion: Double odontoid screw insertion is feasible in only 36% of Indians in the transverse plane, whereas 98.4% of the odontoids can accommodate double screws in the sagittal plane. [ABSTRACT FROM AUTHOR]

Objectives: Measurement of the nasal bone is an important part of the genetic sonogram. This study aimed to compare nasal bone length measurements taken in 2 different planes and to determine whether there is consistency between the measurements. Methods: The nasal bone was measured in 103 fetuses whose mothers were admitted to our clinic for second‐trimester ultrasound examinations and who did not have any accompanying diseases. In this prospective study, the gestational ages of fetuses ranged from 19 to 23 weeks. Nasal bones were measured in both coronal and midsagittal planes, and the similarity between the measurements was evaluated. Pearson correlation, Wilcoxon signed rank, and Kruskal‐Wallis tests were used to evaluate the results. Results: The median nasal bone length increased with increasing gestational age in both planes, as expected. There were no statistically significant differences between the fetal nasal bone lengths taken in the midsagittal and coronal planes at 19 to 23 weeks' gestation (P >.05). Conclusions: The coronal plane may be used as an alternative to evaluate the nasal bone in the second trimester of pregnancy. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is an irreversible progressive cerebral disease with most of its symptoms appearing after 60 years of age. Alzheimer's disease has been largely attributed to accumulation of amyloid beta (Aβ), but a complete cure has remained elusive. 18F-Florbetaben amyloid positron emission tomography (PET) has been shown as a more powerful tool for understanding AD-related brain changes than magnetic resonance imaging and computed tomography. In this paper, we propose an accurate classification method for scoring brain amyloid plaque load (BAPL) based on deep convolutional neural networks. A joint discriminative loss function was formulated by adding a discriminative intra-loss function to the conventional (cross-entropy) loss function. The performance of the proposed joint loss function was compared with that of the conventional loss function in three state-of-the-art deep neural network architectures. The intra-loss function significantly improved the BAPL classification performance. In addition, we showed that the mix-up data augmentation method, originally proposed for natural image classification, was also useful for medical image classification. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pilon fractures usually happened during severe injury, associated with compression and comminution of metaphysis and soft tissue injury and primary articular cartilage damage in varying degrees. The treatment is difficult and the prognosis is relatively poor. OBJECTIVE: To explore the clinical effect of application of meta-plate and mini-plate internal fixation for the treatment of anterior comminuted coronal plane Pilon fractures. METHODS: From January 2013 to June 2017, 17 patients of closed anterior comminuted coronal plane Pilon fractures were admitted in Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University. There were 7 males and 10 females, aged from 24 to 62 years, with an average age of 41.3 years. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. Preoperative CT scans and three-dimensional reconstruction confirmed that the main fracture line was in coronal plane and multiple fragments of distal tibial metaphysis were displaced obviously. According to Rüedi-Allgöwer classification, there were 3 cases of type II and 14 cases of type III. Fracture fragments of articular surface were fixed with transverse metacarpophalangeal mini-plate and screws, and the distal tibial coronal fractures were fixed with anterior meta-plate. The ankle and hind foot score of the American Orthopaedic Foot and Ankle Society was used to evaluate the function after surgery. RESULTS AND CONCLUSION: (1) The 17 patients were followed up for 12 to 28 months. All incisions healed in the first stage without complications such as wound infection, skin necrosis, failure of internal fixation and neurovascular injury. Only one patient had redness on the edge of the incision after operation and healed after swelling reduction and dressing change. (2) Fractures healed within 3 to 6 months without delayed union or nonunion. (3) At the last follow-up, the American Orthopaedic Foot and Ankle Society ankle and hind foot score was excellent in 10 cases, good in 5 cases, and average in 2 cases. The excellent and good rate was 88%. (4) The application of transverse mini-plate and screws fixation can effectively support and fix the fracture fragments of articular surface. Combined with anterior meta-plate of distal tibia for the treatment of anterior comminuted coronal plane Pilon fractures can achieve good therapeutic effect, and strengthen biomechanical stability. [ABSTRACT FROM AUTHOR]

Microwave correlation imaging is developed on the basis of the traditional radar imaging. It gets rid of the dependence of the traditional radar imaging on Doppler frequency, providing a new solution for the stationary or quasi-stationary target imaging. In this paper, the coronal plane microwave correlation imaging based on azimuth one-dimensional (1D) array was proposed. The resolution of the two-dimensional (2D) coronal plane along azimuth and elevation directions can be achieved by distributing the array in only one dimension without the synthetic aperture scanning in another dimension. By simulating the detection signals in the coronal plane region, it is determined this imaging method has the imaging resolution capability that is not available in the traditional SAR imaging in the coronal plane. The effectiveness of this imaging method was verified by the image reconstruction with three imaging algorithms. Moreover, the imaging performance including the signal-to-noise ratio was compared and analyzed. [ABSTRACT FROM AUTHOR]

Introduction: To radiographically analyze lower limb alignment in adult asymptomatic professional football players and to correlate these values to clinical measurements.Materials and Methods: Twenty-four asymptomatic players [24.2 (3.6) years] were enrolled. Standard bilateral lower limb anteroposterior weight-bearing radiographs were acquired and clinical measurement of intercondylar/intermalleolar (ICD/IMD) distance was performed. Coronal plane mechanical alignment was assessed by five angles: leg mechanical axis (LMA), lateral proximal femoral angle (LPFA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA). Their values were compared to the reference values for adult population. An inter-individual comparison between right/left and dominant/non-dominant leg was added. The sum of bilateral LMA was correlated against ICD/IMD and against ICD/IMD adjusted for body height.Results: Football players presented with ICD/IMD of 46.5 (19.8) mm. Two, out of five, lower leg coronal angles showed significant differences (p < 0.001) compared to reference data from literature: LMA 5.8 (3.0)º vs.1.2 (2.2)º and MPTA 83.5 (2.6)º vs. 87.2 (1.5)º. No significant differences between left/right leg and dominant/non-dominant leg were established. Summed up bilateral LMA showed a high correlation to IMD/ICD (r = 0.8395; R2 = 0.7048), and even higher to ICD/IMD adjusted for body height (r = 0.8543; R2 = 0.7298).Conclusions: This study was radiographically confirming increased varus of elite football players toward general population. Apex of the varus deformity was located in the proximal tibia. Clinical measurement of ICD/IMD adjusted for body height highly correlated with the radiographic values of coronal alignment; therefore, it may be used in population studies. [ABSTRACT FROM AUTHOR]

Abstract Background Forefoot structure is important to understand some foot problems such as hallux valgus and metatarsalgia. Ultrasonography (US) is a highly portable, noninvasive, low cost, and fast imaging method, especially when compared to magnetic resonance imaging (MRI), computed tomography (CT), and radiography. As the use of US for evaluating forefoot bony structure has not been validated, except for the presence of synovitis, erosions and bursitis within the forefoot in people with inflammatory arthritis, the purpose of this study was to determine whether US is a reliable method for evaluating forefoot structure. Methods Sixty feet (30 women, age = 40.1 ± 11.8 years) were examined by US and CT to assess agreement with CT and repeatability of US evaluation of the 2nd metatarsal head height, length between the medial sesamoid bone and 5th metatarsal head, transverse arch height, transverse arch index, sesamoid rotation angle, and area under the transverse arch. The measurement data were evaluated for agreement with CT using the intra-class correlation coefficient (ICC)3, 1, Pearson correlation coefficient, and Bland-Altman plot, and with ICC1, 1 for repeatability. Results The ICC3, 1 values of 0.78–0.89, Pearson correlation coefficient of 0.78–0.90, and Bland-Altman plots showed almost perfect agreements between the US and CT method for all parameters, except the area under the transverse arch (AUTA). The ICC1, 1 also showed perfect agreements (0.84–0.92) between two sets of US measurements in all parameters. Conclusions The US evaluation of forefoot structure in the coronal plane showed good agreement with CT and repeatability of two ultrasonograms in adult women. This reliable evaluation method of forefoot structure can contribute to a quick clinical assessment screening for risk factors of foot problems such as hallux valgus and metatarsalgia. However, because of some limitations such as a lack of inter-observer reliability, more research is needed to validate US evaluation of forefoot structure. Trial registration The current study (trial registration number: R0297) was approved by the Ethical Committee for Human Experiments of Kyoto University ( http://www.ec.med.kyoto-u.ac.jp ) on December 3, 2015. The first participant in this study was enrolled on November 17, 2015 and retrospectively registered.