传统放射摄影与计算机断层扫描评估桡骨远端骨折。
Traditional radiography versus computed tomography to assess reduced distal radius fractures.
机构信息
Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, 3000 CA, P.O. Box 2040, Rotterdam, The Netherlands.
Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
出版信息
Eur J Trauma Emerg Surg. 2024 Oct;50(5):2313-2321. doi: 10.1007/s00068-024-02598-5. Epub 2024 Jul 10.
INTRODUCTION
This study compares computed tomography (CT) with plain radiography in its ability to assess distal radius fracture (DRF) malalignment after closed reduction and cast immobilization.
METHODS
Malalignment is defined as radiographic fracture alignment beyond threshold values according to the Dutch guideline encompassing angulation, inclination, positive ulnar variance and intra-articular step-off or gap. After identifying 96 patients with correct alignment on initial post-reduction radiographs, we re-assessed alignment on post-reduction CT scans.
RESULTS
Significant discrepancies were found between radiographs and CT scans in all measurement parameters. Notably, intra-articular step-off and gap variations on CT scans led to the reclassification of the majority of cases from correct alignment to malalignment. CT scans showed malalignment in 53% of cases, of which 73% underwent surgery.
CONCLUSION
When there is doubt about post-reduction alignment based on radiograph imaging, additional CT scanning often reveals malalignment, primarily due to intra-articular incongruency.
简介
本研究比较了计算机断层扫描（CT）与普通 X 光在评估闭合复位和石膏固定后桡骨远端骨折（DRF）对线不良方面的能力。
方法
根据荷兰指南，对线不良定义为超出阈值的影像学骨折对线，包括角度、倾斜度、阳性尺侧变异和关节内台阶或间隙。在确定了 96 例初始复位后 X 线片对线正确的患者后，我们在复位后 CT 扫描上重新评估了对线情况。
结果
在所有测量参数中，X 线片和 CT 扫描之间存在显著差异。值得注意的是，CT 扫描上关节内台阶和间隙的变化导致大多数病例从对线正确重新分类为对线不良。CT 扫描显示 53%的病例存在对线不良，其中 73%的病例接受了手术。
结论
如果基于 X 线成像对复位后的对线有疑问，通常会通过额外的 CT 扫描来发现对线不良，主要是由于关节内的不匹配。
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