Accuracy of radiographic measurements of fracture-induced deformity in the distal radius.
distal radius fracture
dorsal tilt
measurements accuracy
radial inclination
ulnar variance
Journal
Acta radiologica open
ISSN: 2058-4601
Titre abrégé: Acta Radiol Open
Pays: England
ID NLM: 101651010
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
15
05
2023
accepted:
20
09
2023
medline:
28
9
2023
pubmed:
28
9
2023
entrez:
28
9
2023
Statut:
epublish
Résumé
Management of the distal radius fracture (DRF) is to some extent based on radiographic characterization of fracture displacement. It remains unclear, however, if the measurements used to quantify displacement are accurate. To quantify accuracy of two radiographic measurements: dorsal/volar tilt and fracture compression, measured indirectly as ulnar variance (UV), using radiostereometric analyses (RSA) as reference standard. Twenty-one fresh frozen non-fractured human cadaveric forearms (right = 11, left = 10) were thawed and eligible for inclusion. The forearms were mounted on a custom made platform that allowed for controlled forearm rotation, and they underwent two rounds of imaging (both rounds consisted of RSA and radiographs). In round one, the non-fractured forearms were radiographed. In round two, artificial DRF´s with compression and dorsal angulation were created and imaging procedures repeated. Change in tilt and UV between the non-fractured and later fractured forearms was defined as fracture-induced deformity. Deformity was measured radiographically and additionally calculated using RSA. Bland Altman analyses were used to estimate agreement between radiographically measured, and RSA calculated, fracture-induced deformity. Our results indicated that radiographs underestimate the amount of fracture-induced deformity. Mean measured differences (bias) in dorsal tilt deformity between radiographs and RSA were -2.5° for both observers. The corresponding values for UV were -1.4 mm and -1.5 mm. Quantifying fracture-induced deformity on radiographs underestimated the actual deformity when compared to RSA calculated deformity. These findings suggest that clinicians, at least in part, base fracture management and potentially corrective surgery on inaccurate measurements.
Sections du résumé
Background
UNASSIGNED
Management of the distal radius fracture (DRF) is to some extent based on radiographic characterization of fracture displacement. It remains unclear, however, if the measurements used to quantify displacement are accurate.
Purpose
UNASSIGNED
To quantify accuracy of two radiographic measurements: dorsal/volar tilt and fracture compression, measured indirectly as ulnar variance (UV), using radiostereometric analyses (RSA) as reference standard.
Material and Methods
UNASSIGNED
Twenty-one fresh frozen non-fractured human cadaveric forearms (right = 11, left = 10) were thawed and eligible for inclusion. The forearms were mounted on a custom made platform that allowed for controlled forearm rotation, and they underwent two rounds of imaging (both rounds consisted of RSA and radiographs). In round one, the non-fractured forearms were radiographed. In round two, artificial DRF´s with compression and dorsal angulation were created and imaging procedures repeated. Change in tilt and UV between the non-fractured and later fractured forearms was defined as fracture-induced deformity. Deformity was measured radiographically and additionally calculated using RSA. Bland Altman analyses were used to estimate agreement between radiographically measured, and RSA calculated, fracture-induced deformity.
Results
UNASSIGNED
Our results indicated that radiographs underestimate the amount of fracture-induced deformity. Mean measured differences (bias) in dorsal tilt deformity between radiographs and RSA were -2.5° for both observers. The corresponding values for UV were -1.4 mm and -1.5 mm.
Conclusion
UNASSIGNED
Quantifying fracture-induced deformity on radiographs underestimated the actual deformity when compared to RSA calculated deformity. These findings suggest that clinicians, at least in part, base fracture management and potentially corrective surgery on inaccurate measurements.
Identifiants
pubmed: 37767057
doi: 10.1177/20584601231205986
pii: 10.1177_20584601231205986
pmc: PMC10521277
doi:
Types de publication
Journal Article
Langues
eng
Pagination
20584601231205986Informations de copyright
© The Author(s) 2023.
Déclaration de conflit d'intérêts
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Hand Clin. 2005 Aug;21(3):279-88
pubmed: 16039439
J Orthop Trauma. 2008 Sep;22(8 Suppl):S96-105
pubmed: 18753897
Stat Methods Med Res. 1999 Jun;8(2):135-60
pubmed: 10501650
J Orthop Res. 2018 Nov;36(11):3053-3063
pubmed: 29873422
J Hand Surg Glob Online. 2021 Jun 08;3(4):182-189
pubmed: 35415563
Eur Radiol Exp. 2021 Apr 2;5(1):15
pubmed: 33796970
J Hand Surg Am. 2018 Oct;43(10):951.e1-951.e9
pubmed: 29602655
Acta Orthop. 2005 Aug;76(4):563-72
pubmed: 16195075
BMJ Open. 2016 Nov 14;6(11):e012799
pubmed: 28137831
Hand Surg. 2005 Jul;10(1):17-22
pubmed: 16106496
J Hand Surg Am. 2001 May;26(3):415-21
pubmed: 11418901
J Hand Surg Eur Vol. 2009 Apr;34(2):166-72
pubmed: 19129357
J Bone Joint Surg Am. 2009 Dec;91(12):2984-91
pubmed: 19952264
J Hand Surg Am. 2020 Oct;45(10):984.e1-984.e7
pubmed: 32327340
J Hand Surg Am. 1989 Jul;14(4):607-12
pubmed: 2754190
Arch Bone Jt Surg. 2015 Oct;3(4):250-3
pubmed: 26550588
Radiology. 1997 Dec;205(3):865-9
pubmed: 9393549
J Orthop Res. 2005 Mar;23(2):481-8
pubmed: 15734266
Hand (N Y). 2022 Mar;17(2):331-338
pubmed: 32506961
J Hand Surg Eur Vol. 2013 Feb;38(2):133-43
pubmed: 22736743
Diagnostics (Basel). 2020 May 22;10(5):
pubmed: 32456091
Acta Radiol. 2019 Nov;60(11):1482-1489
pubmed: 30845815
J Bone Joint Surg Am. 2011 Apr 20;93(8):775-8
pubmed: 21508285
Acta Orthop Scand Suppl. 1989;232:1-51
pubmed: 2686344