title: An X-ray template assessment for distal radial fractures.
abstract: BACKGROUND
  The current method for radiological measurements on plain X-rays of distal radius fractures is unreliable. We examined the reproducibility of a new X-ray assessment technique-where the uninjured side is used as a template for the injured side-compared to the conventional assessment technique.
  
  
  METHODS
  X-rays of 30 patients with a unilateral distal radial fracture were included reflecting the prevalence of AO fracture types in clinical practice. Eight experienced observers assessed these X-rays on two separated occasions (2-month interval) using the traditional measurement technique and the template technique. Reproducibility of the X-ray assessments was quantified by intraclass correlations and weighted kappa coefficients.
  
  
  RESULTS
  The reproducibility of the radial length measurement did not improve nor did the volar angulation measurement. However, marked improvement in reproducibility was observed for the radial inclination measurement, the kappa increased from 0.36 (95 % CI; 0.30-0.41) to 0.49 (95 % CI; 0.43-0.55) in the template technique. As a result, the classification of the reduction results (Lidström score) greatly improved. The overall kappa for the Lidström score improved from 0.37 (95 % CI; 0.31/0.43) to 0.59 (0.52/0.63).
  
  
  CONCLUSIONS
  The assessment technique using the uninjured side as a template for the injured side resulted only in an improved reproducibility of the radial inclination measurement which in turn resulted in an improved classification reproducibility of the reduction results.
authors.affiliation: Department of Surgery/Traumatology, Máxima Medical Center, PO Box 90052, 5600 PD Eindhoven, The Netherlands. p.vaneerten@mmc.nl
authors.forename: P V
authors.initials: PV
authors.lastname: van Eerten
authors.forename: R
authors.initials: R
authors.lastname: Lindeboom
authors.forename: A E
authors.initials: AE
authors.lastname: Oosterkamp
authors.forename: J C
authors.initials: JC
authors.lastname: Goslings
mesh_terms: D000293:Adolescent; D006801:Humans; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D013679:Technology, Radiologic