Computed tomography scanning with image reconstruction in evaluation of distal radius fractures.

Seventeen patients with 18 intraarticular distal radius fractures underwent computed tomography (CT) scanning and image reconstruction to evaluate their distal radius fractures. All patients were selected prospectively because of intraarticular extension and/or displacement of their fractures on pre- or post reduction plain films. Patients who were not surgical candidates for open reduction and internal fixation of their fracture were not included in the study. X-ray films and CT scans were viewed separately and in random order by a senior radiologist not familiar with the cases. Both x-ray films and CT scans readily showed extension of fracture lines into the radiocarpal joint, radial shaft, and the ulnar styloid, but CT scans were better than x-ray films at demonstrating fracture involvement of the distal radioulnar joint, the extent of articular surface depression, and the amount of comminution. Due to the cost, it is recommended that the test only be used for patients who are surgical candidates for open reduction and internal fixation or when more information about the extent of comminution and joint depression is required.