ArticleTomography (Ann Arbor, Mich.)2026
CT-Based Three-Dimensional Volumetric Analysis of Posterior and Lateral Malleolar Fragments in SER-Type Trimalleolar Ankle Fractures: Correlation and Reproducibility Study.
Article in Tomography (Ann Arbor, Mich.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPosterior malleolar fractures are commonly assessed using two-dimensional measurements and morphology-based classification systems. However, ankle fracture morphology is inherently three-dimensional, and the reproducibility of CT-based volumetric segmentation for malleolar fracture fragments has not been sufficiently established.
objectivesThis study aimed to evaluate the relationship between lateral and posterior malleolar fragment volumes in homogeneous supination-external rotation (SER)-type trimalleolar ankle fractures and to assess the intraobserver and interobserver reproducibility of a manual CT-based three-dimensional volumetric segmentation workflow.
methodsThis retrospective musculoskeletal imaging study included 71 patients with SER-type trimalleolar ankle fractures who underwent preoperative computed tomography (CT). Posterior and lateral malleolar fracture fragments were segmented on thin-slice axial CT images using a standardized manual contour-based slice-by-slice workflow. Fragment volumes were calculated using dedicated volumetric imaging software. The association between lateral and posterior malleolar fragment volumes was assessed using Spearman correlation and multivariable linear regression analyses. Measurement reproducibility was evaluated using intraclass correlation coefficients for absolute agreement [ICC(A,1)] and Bland-Altman analyses.
resultsThe median lateral and posterior malleolar fragment volumes were 8.63 cm
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