The Availability of Three-Dimensional Computed Tomography Reconstructions on the Classification and Treatment Plan of Distal Radius Fractures

ABSTRACT

PURPOSE: The purpose of this study is to determine whether the three-dimensional computed tomography (3D-CT) images would increase the reliability of fracture classification and influence treatment plan of distal radius fractures. MATERIALS AND METHODS: Four independent observers evaluated radiographic images of thirty patients with distal radius fractures. The fracture classification has been performed based on (1) AO classification, (2) Fernandez classification, (3) Frykman classification. And then treatment plan was planned based on (1) closed reduction with Sugar-tong splint, (2) closed reduction with pinning, (3) closed reduction with external fixator, (4) open reduction with plate (volar approach), (5) open reduction with plate (dorsal approach). Two rounds of evaluation were compared regarding (1) simple radiographs alone, and (2) simple radiographs and 3D-CT together two weeks after that. This cycle was then repeated to assess intraobserver reliability. RESULTS: 3D-CT improved the intraobserver and interobserver reliability regarding the fracture classification and treatment plan. And the addition of 3D-CT to simple radiographs influenced treatment recommendations, resulting in a significantly greater number of decisions for an open approach (p<0.05, McNemar test). CONCLUSIONS: 3D-CT is a reliable tool of fracture classification and improves treatment plan of distal radius fractures.