title: Evaluation of the sigmoid notch involvement in the intra-articular distal radius fractures: the efficacy of computed tomography compared with plain X-ray.
abstract: BACKGROUND
  The purpose of this study is to evaluate the efficacy of computed tomography (CT) scans compared with plain radiographs on detecting the involvement of the sigmoid notch.
  
  
  METHODS
  This study involved 121 cases diagnosed as the intra-articular distal radius fracture and performed post-reduction CT scans. We determined the presence of the sigmoid notch involvement with both plain radiographs and CT scans and compared findings of plain radiographs with CT scans about the incidence and the pattern of injuries. And the differences of results between arbeitsgemeinschaft für osteosyntheses (AO) type C2 and C3 were compared.
  
  
  RESULTS
  The incidences of sigmoid notch involvement detected in plain radiographs were 81 cases (66.9%), whereas CT scans were 99 cases (81.9%). The sensitivity of plain radiographs compared with CT scans was 74.7%, the specificity was 68.2%, the positive predictive value was 91.4%, the negative predictive value was 37.5%, the false negative value was 25.3%, and the false positive value was 31.8%. In comparison between AO type C2 and C3, the incidence of sigmoid notch involvement was not a significant difference, but the displacement of fracture fragment showed a significant difference.
  
  
  CONCLUSIONS
  The intra-articular distal radius fracture usually accompanies the sigmoid notch involvement. Considering that the evaluation of sigmoid notch involvement by plain radiography often results in misinterpretation or underestimation, performing CT scan in intra-articular distal radius fracture is thought to be beneficial.
authors.affiliation: Department of Orthopedic Surgery, Konyang University Hospital, Daejeon, Korea.
authors.forename: Youn Moo
authors.initials: YM
authors.lastname: Heo
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Roh
authors.forename: Sang-Bum
authors.initials: SB
authors.lastname: Kim
authors.forename: Jin Woong
authors.initials: JW
authors.lastname: Yi
authors.forename: Kwang Kyoon
authors.initials: KK
authors.lastname: Kim
authors.forename: Byung Hak
authors.initials: BH
authors.lastname: Oh
authors.forename: Hyeong-Tak
authors.initials: HT
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011885:Radius Fractures / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult