1Orthopaedic Hand and Upper Extremity Service,
Massachusetts General Hospital, Boston, USA
2Emergency Department, Reinier de Graaf Gasthuis, Delft,
3Surgery Department, Medisch Centrum Haaglanden, Den
Haag, The Netherlands
4Radiology Department, Medisch Centrum Haaglanden,
Den Haag, The Netherlands
5Department of Bioinformatics, Erasmus MC University
Medical Center, Rotterdam, Netherlands
Background: The I-Space is a radiological imaging system in which Computed Tomography (CT)-scans can be evaluated as a three dimensional hologram. The aim of this study is to analyze the value of virtual reality (I-Space) in diagnosing acute occult scaphoid fractures.
Methods: A convenient cohort of 24 patients with a CT-scan from prior studies, without a scaphoid fracture on radiograph, yet high clinical suspicion of a fracture, were included in this study. CT-scans were evaluated in the I-Space by 7 observers of which 3 observers assessed the scans in the I-Space twice. The observers in this study assessed in the I-Space whether the patient had a scaphoid fracture. The kappa value was calculated for inter- and intra-observer agreement. Results: The Kappa value varied from 0.11 to 0.33 for the first assessment. For the three observers who assessed the CT-scans twice; observer 1 improved from a kappa of 0.33 to 0.50 (95% CI 0.26-0.74, P=0.01), observer 2 from 0.17 to 0.78 (95% CI 0.36-1.0, P<0.001), and observer 3 from 0.11 to 0.24 (95% CI 0.0-0.77, P=0.24). Conclusion: Following our findings the I-Space has a fast learning curve and has a potential place in the diagnostic modalities for suspected scaphoid fractures.