MDCT evaluation of distal radius fractures and their association with carpal and distal ulnar fractures.
Carpal bones
Multidetector computed tomography
Radius fractures
Ulna fractures
Wrist fractures
Journal
Emergency radiology
ISSN: 1438-1435
Titre abrégé: Emerg Radiol
Pays: United States
ID NLM: 9431227
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
30
06
2023
accepted:
25
08
2023
medline:
27
9
2023
pubmed:
1
9
2023
entrez:
1
9
2023
Statut:
ppublish
Résumé
The purpose of this study was to evaluate the characteristics of distal radius fractures (DRFs) in patients undergoing multi-detector computed tomography (MDCT) and their association with carpal and distal ulnar fractures. This retrospective study analyzed 120 patients, who underwent MDCT for evaluation of DRFs. Two radiologists independently evaluated the data for various fracture characteristics and for associated carpal and distal ulnar fractures. Out of 120 DRFs, 74 were complete articular, 40 were partial articular and only 6 were extra-articular. Displacement was present in 99 fractures and intra-articular step off was present in 73 fractures. A total of 81 carpal bone fractures were identified in 46 (38.3%) patients, with more than one carpal bone fracture in 21 patients. Distal ulnar fractures were detected in 79 patients (65.8%), out of which 67 involved the ulnar styloid. DRFs with intra-articular step off were more frequently associated with carpal bone fracture (p value: 0.021), while displaced DRFs were more frequently associated with distal ulnar fracture (p value <0.001). Interobserver agreement for detection of carpal bone fractures (κ = 0.807) and distal ulnar fractures (κ = 0.923) was excellent. Majority of DRFs in patients referred for MDCT were complete articular with high incidence of displacement and intra-articular step off. Associated carpal bone and distal ulna fractures were not uncommon.
Identifiants
pubmed: 37656265
doi: 10.1007/s10140-023-02169-y
pii: 10.1007/s10140-023-02169-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
629-635Informations de copyright
© 2023. The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER).
Références
Nellans KW, Kowalski E, Chung KC (2012) The epidemiology of distal radius fractures. Hand Clin 28:113–125
doi: 10.1016/j.hcl.2012.02.001
pubmed: 22554654
pmcid: 3345129
Turner RG, Faber KJ, Athwal GS (2010) Complications of distal radius fractures. Hand Clin [Internet] 26(1):85–96 Available from: https://www.sciencedirect.com/science/article/pii/S0749071209000973
doi: 10.1016/j.hcl.2009.08.005
pubmed: 20006247
Katz MA, Beredjiklian PK, Bozentka DJ, Steinberg DR (2001) Computed tomography scanning of intra-articular distal radius fractures: does it influence treatment? J Hand Surg Am 26(3):415–421
doi: 10.1053/jhsu.2001.22930a
pubmed: 11418901
Heo YM, Kim SB, Yi JW, Lee JB, Park CY, Yoon JY et al (2013) Evaluation of associated carpal bone fractures in distal radial fractures. Clin Orthop Surg 5(2):98–104. https://doi.org/10.4055/cios.2013.5.2.98
doi: 10.4055/cios.2013.5.2.98
pubmed: 23730472
pmcid: 3664678
May MM, Lawton JN, Blazar PE (2002) Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg Am 27(6):965–971
doi: 10.1053/jhsu.2002.36525
pubmed: 12457345
Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF (2018) Fracture and dislocation classification compendium—2018. J Orthop Trauma 1(32):S1–S0
doi: 10.1097/BOT.0000000000001063
Etli I, Kozaci N, Avci M, Karakoyun OF (2020) Comparison of the diagnostic accuracy of X-ray and computed tomography in patients with wrist injury. Injury 51(3):651–655
doi: 10.1016/j.injury.2020.01.034
pubmed: 32014259
Balci A, Basara I, Çekdemir EY, Tetik F, Aktaş G, Acarer A, Özaksoy D (2015) Wrist fractures: sensitivity of radiography, prevalence, and patterns in MDCT. Emerg Radiol 22:251–256
doi: 10.1007/s10140-014-1278-1
pubmed: 25325932
Welling RD, Jacobson JA, Jamadar DA, Chong S, Caoili EM, Jebson PJ (2008) MDCT and radiography of wrist fractures: radiographic sensitivity and fracture patterns. Am J Roentgenol 190(1):10–16
doi: 10.2214/AJR.07.2699
Komura S, Yokoi T, Nonomura H, Tanahashi H, Satake T, Watanabe N (2012) Incidence and characteristics of carpal fractures occurring concurrently with distal radius fractures. J Hand Surg Am 37(3):469–476
doi: 10.1016/j.jhsa.2011.11.011
pubmed: 22321439
Arora S, Grover SB, Batra S, Sharma VK (2010) Comparative evaluation of postreduction intra-articular distal radial fractures by radiographs and multidetector computed tomography. JBJS 92(15):2523–2532
doi: 10.2106/JBJS.I.01617
Papp S (2010) Carpal bone fractures. Hand Clin 26(1):119–127
doi: 10.1016/j.hcl.2009.08.014
pubmed: 20006250
Kaewlai R, Avery LL, Asrani A, Abujudeh HH, Sacknoff R, Novelline RA (2008) Multidetector CT of carpal injuries: anatomy, fractures, and fracture-dislocations. Radiographics 28(6):1771–1784
doi: 10.1148/rg.286085511
pubmed: 18936035
Borgeskov S, Christiansen B, Kjaer A, Balslev I (1966) Fractures of the carpal bones. Acta Orthop Scand 37(3):276–287
doi: 10.3109/17453676608989415
pubmed: 5955131
Christie BM, Michelotti BF (2019) Fractures of the Carpal Bones. Clin Plast Surg [Internet] 46(3):469–477 Available from: https://www.sciencedirect.com/science/article/pii/S0094129819300318
doi: 10.1016/j.cps.2019.03.007
pubmed: 31103090
Herzberg G, Castel T (2016) Incidence des fractures de l’extrémité distale de l’ulna associées aux fractures de l’extrémité distale du radius (processus styloïde ulnaire). Nos choix thérapeutiques. Hand Surg Rehabil [Internet] 35:S69–S74 Available from: https://www.sciencedirect.com/science/article/pii/S2468122916301104
doi: 10.1016/j.hansur.2016.09.005
Illarramendi A, Gonza Âlez A, Valle D, Segal E, de Carli P, Maignon G et al (1998) Evaluation of simplified Frykman and AO classifications of fractures of the distal radius: Assessment of interobserver and intraobserver agreement. Int Orthop 22:111–115
doi: 10.1007/s002640050220
pubmed: 9651777
pmcid: 3619715
Arealis G, Galanopoulos I, Nikolaou VS, Lacon A, Ashwood N, Kitsis C (2014) Does the CT improve inter-and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures? Injury 45(10):1579–1584
doi: 10.1016/j.injury.2014.06.017
pubmed: 25042062
Peña-Martínez VM, Villanueva-Guerra E, Tamez-Mata Y, Simental-Mendía M, Gallardo-Madrid A, Blázquez-Saldaña J et al (2022) Distal radius fractures: classifications concordance among orthopedic residents on a teaching hospital. Journal of Orthopaedic Science [Internet] Available from: https://www.sciencedirect.com/science/article/pii/S09492658220032