• OBJECTIVES
    • 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.
  • DESIGN
    • Retrospective Review.
  • SETTING
    • Level I Trauma Center.
  • PATIENTS/PARTICIPANTS
    • A total of 153 patients with closed lower extremity fractures.
  • INTERVENTION
    • CT scans of identified individuals were reviewed for the presence or absence of gaseous accumulations.
  • MAIN OUTCOME MEASUREMENTS
    • The presence or absence of gas on CT.
  • RESULTS
    • 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 = 0.002).
  • CONCLUSIONS
    • 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.
  • LEVEL OF EVIDENCE
    • Level IV.