title: Postoperative monitoring of distal intraarticular radial fractures treated with osteosynthesis by means of multislice CT.
abstract: OBJECTIVE
  This study evaluates multislice CT (MSCT) for the postsurgical control of intraarticular fractures of the distal radius.
  
  
  METHODS
  In 131 patients conventional X-rays in two planes and MSCT were performed. In a consensus process two experienced radiologists judged conventional X-ray and computed tomography images in a random view. The correct position of the osteosynthetic material was assessed and it was ascertained whether an articular surface incongruity, a gap between two fracture fragments, or an intraarticular bone element was detectable. For each point of evaluation a confidence level of the evaluation was assessed on a five-point scale.
  
  
  RESULTS
  Ninety patients were classified as having correct alignment and osteosynthesis according to conventional X-ray, while when using the findings from axial CT scans only, 82 patients, and after the addition of multiplanar re-constructions (MPR) only 73 patients were found to have almost proper alignment and osteosynthesis. In 42 patients dehiscence of the fragments was diagnosed with MSCT, but was not visualized by X-ray, leading to surgical revision in eight patients, confirming the diagnosis. In five patients an intraarticular position of intraarticular material was confirmed with MSCT and surgical revision. A significant advantage for the evaluation confidence level was achieved for MPRs in comparison with axial CT scans and X-ray.
  
  
  CONCLUSIONS
  The marked diagnostic advantage with a high evaluation confidence level in comparison with conventional X-ray methods justify the use of MSCT during postoperative monitoring of articular radial fractures treated with osteosynthesis.
authors: Department of Radiology, University of Hamburg, Germany.
authors: M
authors: M
authors: Lorenzen
authors: U
authors: U
authors: Wedegärtner
authors: C
authors: C
authors: Weber
authors: G
authors: G
authors: Adam
authors: J
authors: J
authors: Lorenzen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D001860:Bone Plates; D001864:Bone Wires; D016267:External Fixators; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D017759:Fractures, Malunited / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D012086:Reoperation; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014954:Wrist Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D055815:Young Adult