Treatment of distal radial fractures with the DVR-A plate--the early Bristol experience.

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Abstract

[Indexed for MEDLINE] 15. J Orthop Sci. 2017 May;22(3):434-437. doi: 10.1016/j.jos.2016.12.024. Epub 2017 Jan 20. The role of CT scan in postoperative evaluation of distal radius fractures: Retrospective analysis in regard to complications and revision rates. Jakubietz MG(1), Mages L(2), Zahn RK(3), Kenn W(4), Jakubietz RG(2), Meffert RH(2). Author information: (1)Department of Trauma-, Hand-, Plastic and Reconstructive Surgery, University of Wuerzburg, Wuerzburg, Germany. Electronic address: Jakubietz_M@ukw.de. (2)Department of Trauma-, Hand-, Plastic and Reconstructive Surgery, University of Wuerzburg, Wuerzburg, Germany. (3)Center for Musculoskeletal Surgery, Department for Orthopaedics, Charité-University Berlin, Berlin, Germany; Center for Musculoskeletal Surgery, Department for Traumatology, Charité-University Berlin, Berlin, Germany. (4)Department of Diagnostic and Interventional Radiology, University of Wuerzburg, Wuerzburg, Germany. BACKGROUND: Intraarticular fractures of the distal radius present a challenging problem for surgeons. While preoperative CT scans are considered helpful to understand the type of fracture and to choose an adequate approach, the role of postoperative CT scans is not yet clearly defined. The aim of this study was to analyze indications for postoperative CT scans and to evaluate its potential therapeutic consequence in regard to detection of complications and its influence on revision rates in intraarticular fractures. These findings were used to establish an algorithm to help identifying patients that benefit from a postoperative CT scan. PATIENTS AND METHODS: Ninety-two patients with intraarticular fractures were included. AO type C fractures were seen in about 90% of patients, with type C3 being present in 55% of the patients. According to Frykman's classification type 7 and 8 fractures were found in 93%. Data was analyzed in regard to radiographic results, complications and indication for a postoperative CT scan. RESULTS: Six patients underwent revision surgery. When analyzing data in regard to correlation of radiographs and CT Scans a statistically significant correlation was found. CONCLUSIONS: A high correlation between both imaging techniques can be shown. In inconclusive radiographs, CT scans are recommended to rule out intraarticular screw placement or step offs. Due to the number of patients and the retrospective design, further studies are needed. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved. DOI: 10.1016/j.jos.2016.12.024