Evaluation of calcaneal fractures by multi detector ct and its significant effect on the surgical management planning

Background: Familiarity with the normal calcaneal anatomy is important for understanding fracture mechanisms and classification schemes. Clinical presentation at the time of evaluation generally includes [a] a history of a fall from a height, and [b] certain signs that aid the physician in identifying possible calcaneal fractures

Purpose: To look at the role played by the multi detector computed tomography [MDCT] in assessing calcaneus fractures and delineate the fracture fragment which help in decision making in the management of extra and intra articular fractures of the calcaneum and pre-operative planning

Patients and Methods: This study will be conducted on patients with calcaneal fractures suspected clinically or by x ray diagnosis. The patient will be referred from orthopaedic department at Ain Shams University Hospitals; the patient will be investigated using MDCT

Results: This study included 44 feet of 41 patients [three bilateral]; 35 males and 6 females, representing 85.4% and 14.6% of all patients respectively, their mean age was 34.22 years, we observed that calcaneal fractures commonly occur in male than female

Conclusion: Multi detector CT is the best method of assessing calcaneus fracture in order to decide management. It delineates the fracture fragments and help in making the pre-operative planning of the fracture

Pancreatic tumor resectability: spiral CT, surgical and pathological assessment

Resectability of pancreatic tumors can be difficult to assess. The initial investigations [abdominal ultrasonography and; conventional C.T.scans] may fail to assess the resectability of pancreatic tumors in up to 30% of cases. The aim of this retrospective study was to evaluate the accuracy of spiral computed tomography [C.T.] in assessing the resectability of small pancreatic ductal adenocarcinoma and; to correlate the C.T findings with histopathologic and surgical findings. Spiral C.T. scans were obtained in fifteen patients who underwent surgery for potentially resectable pancreatic adenocarcinoma. C.T. findings were correlated with surgically assessed extent of tumor and pathological findings. Twelve patients had resection of the tumor with pancreaticoduodenectomy operation Three patients proved during operation inoperable due to the presence of small [< 1 cm] hepatic metastatic deposits [2 patients] and peritoneal and omental seedling in one patient. We concluded that thin-section helical CT is a useful application in the diagnostic imaging of pancreatic tumor and in determining tumor resectability