Computational area measurement of orbital floor fractures: Reliability, accuracy and rapidity

Objective: To evaluate the reliability, accuracy and rapidity of a specific computational method for assessing the orbital floor fracture area on a CT scan. Method: A computer assessment of the area of the fracture, as well as that of the total orbital floor, was determined on CT scans taken from ten patients. The ratio of the fracture's area to the orbital floor area was also calculated. The test-retest precision of measurement calculations was estimated using the Intraclass Correlation Coefficient (ICC) and Dahlberg's formula to assess the agreement across observers and across measures. The time needed for the complete assessment was also evaluated. Results: The Intraclass Correlation Coefficient across observers was 0.92 [0.85;0.96], and the precision of the measures across observers was 4.9%, according to Dahlberg's formula. The mean time needed to make one measurement was 2 min and 39 s (range, 1 min and 32 s to 4 min and 37 s). Conclusion: This study demonstrated that (1) the area of the orbital floor fracture can be rapidly and reliably assessed by using a specific computer system directly on CT scan images; (2) this method has the potential of being routinely used to standardize the post-traumatic evaluation of orbital fractures. (C) 2011 Elsevier Ireland Ltd. All rights reserved.