title: The evaluation of a new digital semi-automated system for the radiological assessment of distal radial fractures.
abstract: OBJECTIVE
  To compare intra- and inter-observer variation for measurements of wrist deformity using a manual method of measurement and a semi-automated digital system developed in our department.
  
  
  METHODS
  Four observers measured radial angle, radial shift, radial length, palmar tilt, and dorsal shift on ten wrist-fracture films using a standardised protocol. Each observer made measurements directly from the radiograph on three occasions, and on a further three occasions digitised images were viewed and measurements made with semi-automated on-screen measurement tools.
  
  
  RESULTS
  Manual measurements took 12 min per case compared with 3 min for the digital system. The digital system resulted in improved intra-observer variation for all measurements and an improvement in inter-observer variation for all measurements except posterior tilt.
  
  
  CONCLUSIONS
  The new system allows greater precision in assessing fracture reduction and follow-up. Its principal application is in studies that utilise the wrist as a model for fracture healing.
authors.affiliation: Department of Radiology, Leeds General Infirmary, Leeds, UK. andrew.grainger@leedsth.nhs.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Grainger
authors.forename: J
authors.initials: J
authors.lastname: Duryea
authors.forename: J M
authors.initials: JM
authors.lastname: Elliott
authors.forename: H K
authors.initials: HK
authors.lastname: Genant
mesh_terms: D006801:Humans; D007091:Image Processing, Computer-Assisted; D015588:Observer Variation; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012984:Software; D014955:Wrist Joint / Q000000981:diagnostic imaging