The influence of radiographic projection on the appearance of deformities.

Abstract

In a series of 100 malunions and nonunions, the authors found, on average, that the worst deformity visualized radiographically underestimated the true deformity by 14% (range of 0% to 41.4%). By recomputing the analysis as though four views (anteroposterior, lateral, both 45% obliques) had been obtained, the visualization error was reduced from 14% to 2.5%. The authors recommended either obtaining the aforementioned four views when planning a complex deformity correction, or, better yet, obtain the radiographic projection that shows each deformity in profile.