Postoperative monitoring of distal intraarticular radial fractures treated with osteosynthesis by means of multislice CT.
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.
Lorenzen
M
M
Department of Radiology, University of Hamburg, Germany.
Wedegärtner
U
U
Weber
C
C
Adam
G
G
Lorenzen
J
J
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