{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T12:20:33Z","timestamp":1780143633660,"version":"3.54.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11]]},"abstract":"\n Objectives:<\/jats:title>\n To determine the incidence of vacuum phenomenon related intra-articular or subfascial gas found on computer-assisted tomography (CT) scans of closed lower extremity fractures.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective Review.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Level I Trauma Center.<\/jats:p>\n <\/jats:sec>\n \n Patients\/Participants:<\/jats:title>\n A total of 153 patients with closed lower extremity fractures.<\/jats:p>\n <\/jats:sec>\n \n Intervention:<\/jats:title>\n CT scans of identified individuals were reviewed for the presence or absence of gaseous accumulations.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measurements:<\/jats:title>\n The presence or absence of gas on CT.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Twenty seven (17.6%) of the 153 fractures were found to have intra-articular or subfascial gas on CT despite clear documentation, indicating a closed injury with no significant skin compromise. Of the intra-articular fractures (OTA\/AO 33B\/C, 41B\/C and 43B\/C), 20% (23 of 113) were found to have gas on CT. All cases were associated with fracture of the tibia (P<\/jats:italic> = 0.002).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Computed tomography demonstrated the presence of intra-articular or subfascial gas in 17.6% (27\/153) of closed lower extremity fractures and in 20% (23\/113) of closed intra-articular fractures. The possibility of vacuum phenomenon must be considered when using this imaging modality as the confirmatory test for open intra-articular fracture or traumatic arthrotomy.<\/jats:p>\n <\/jats:sec>\n \n Level Of Evidence:<\/jats:title>\n Level IV.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000000962","type":"journal-article","created":{"date-parts":[[2017,8,18]],"date-time":"2017-08-18T22:00:00Z","timestamp":1503093600000},"page":"e381-e384","source":"Crossref","is-referenced-by-count":13,"title":["Incidence of Vacuum Phenomenon Related Intra-articular or Subfascial Gas Found on Computer-Assisted Tomography (CT) Scans of Closed Lower Extremity Fractures"],"prefix":"10.1097","volume":"31","author":[{"given":"Tyler","family":"Noble","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Wellspan York Hospital, York, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M.","family":"Romeo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine, Harborview Medical Center, Seattle, WA; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher T.","family":"LeBrun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"DiPasquale","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Wellspan York Hospital, York, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1097\/BOT.0b013e31828b7001","article-title":"The role of computed tomography in the assessment of open periarticular fractures associated with deep knee wounds","volume":"27","author":"Konda","year":"2013","journal-title":"J Orthop Trauma."},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1097\/BOT.0b013e31828219bc","article-title":"Computed tomography scan to detect traumatic arthrotomies and identify periarticular wounds not requiring surgical intervention: an improvement over the saline load test","volume":"27","author":"Konda","year":"2013","journal-title":"J Orthop Trauma."},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/BOT.0b013e3182821505","article-title":"Computed tomography scan to detect intra-articular air in the knee joint: a cadaver study to define a low radiation dose imaging protocol","volume":"27","author":"Konda","year":"2013","journal-title":"J Orthop Trauma."},{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"933","DOI":"10.2106\/00004623-195032040-00025","article-title":"Vacuum pneumarthography and spontaneous occurrence of gas in joint spaces","volume":"32A","author":"Fuiks","year":"1950","journal-title":"J Bone Joint Surg Am."},{"key":"R6-20230828","first-page":"131","article-title":"Vacuum phenomenon in osteoarthritis of the atlanto-odontoid joint: CT findings","volume":"24","author":"Zapleta","year":"1995","journal-title":"Skeletal Radiol."},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/S1079-2104(98)90216-5","article-title":"Gas in the temporomandibular joint: computed tomography findings","volume":"86","author":"Hayashi","year":"1998","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radio Endod."},{"key":"R8-20230828","first-page":"165","article-title":"Cracking in the metacarpophalangeal joint","volume":"81","author":"Rosten","year":"1947","journal-title":"J Anat."},{"key":"R9-20230828","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S0009-9260(05)80166-7","article-title":"Gas-containing ganglia of the hip","volume":"46","author":"Silver","year":"1992","journal-title":"Clin Radiol."},{"key":"R10-20230828","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1097\/00007632-199709010-00013","article-title":"Vacuum phenomena in the sacroiliac joints and in association with sacral insufficiency fractures. 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