title: Are radiographic measurements of the displacement of a distal radial fracture reliable and reproducible?
abstract: OBJECTIVE
  The degree of displacement of a fracture of the distal radius is an important factor which can be assessed using simple radiographic measurements. Our aim was to investigate the reliability and reproducibility of these measurements and to determine if they should be used clinically.
  
  
  METHODS
  A 10% sample was randomly generated from 3670 consecutive adult patients who had presented to University Hospitals of Leicester NHS Trust between 2007 and 2010 with a fracture of the distal radius. Radiographs of the 367 patients were assessed by two independent reviewers. Four measurements of displacement of the fracture were recorded and the inter-observer correlation assessed using the intra-class correlation coefficient.
  
  
  RESULTS
  Inter-observer correlation was high (> 0.8) for three of the four measurements. Repeat measurements of a further randomly generated 10% sample (37) were made four weeks later to assess intra-observer agreement, which was again high (> 0.8) for the same three parameters (radial height, radial inclination and dorsal/palmar tilt). Correlation was poor for articular step and gap.
  
  
  CONCLUSIONS
  Radiographic assessment of radial angle, radial inclination and dorsal/palmar tilt is a reliable method of determining the degree of displacement of a fracture of the distal radius. Cite this article: Bone Joint J 2016;98-B:1069-73.
authors.affiliation: Undercroft Centre of Orthopaedics, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors.forename: E
authors.initials: E
authors.lastname: Stirling
authors.affiliation: Undercroft Centre of Orthopaedics, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors.forename: J
authors.initials: J
authors.lastname: Jeffery
authors.affiliation: Undercroft Centre of Orthopaedics, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors.forename: N
authors.initials: N
authors.lastname: Johnson
authors.affiliation: Undercroft Centre of Orthopaedics, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
authors.forename: J
authors.initials: J
authors.lastname: Dias
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Displacement; Distal radius fracture; Measurement; Radiograph; X-ray