Abstract：
BACKGROUND: 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.
CONCLUSIONS: When there is doubt about post-reduction alignment based on radiograph imaging, additional CT scanning often reveals malalignment, primarily due to intra-articular incongruency.
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.
CONCLUSIONS: When there is doubt about post-reduction alignment based on radiograph imaging, additional CT scanning often reveals malalignment, primarily due to intra-articular incongruency.
摘要：
背景：这项研究比较了计算机断层扫描（CT）和X线平片在评估闭合复位和石膏固定后桡骨远端骨折（DRF）对齐不良的能力。
方法：不对齐定义为根据荷兰指南，超过阈值的射线照相骨折对齐，包括角度，倾斜度,尺骨正变异和关节内台阶或间隙。在最初的复位后射线照片上确定了96例正确对齐的患者后，我们重新评估了复位后CT扫描的对齐情况.
结果：在所有测量参数中，X线照片和CT扫描之间均存在显著差异。值得注意的是,CT扫描中的关节内阶梯和间隙变化导致大多数病例从正确对齐到对齐不良重新分类。CT扫描显示53%的病例对准不良,其中73%接受了手术。
结论：当基于X射线成像的复位后对齐存在疑问时，额外的CT扫描通常会显示对准不良，主要是由于关节内不一致。
方法：不对齐定义为根据荷兰指南，超过阈值的射线照相骨折对齐，包括角度，倾斜度,尺骨正变异和关节内台阶或间隙。在最初的复位后射线照片上确定了96例正确对齐的患者后，我们重新评估了复位后CT扫描的对齐情况.
结果：在所有测量参数中，X线照片和CT扫描之间均存在显著差异。值得注意的是,CT扫描中的关节内阶梯和间隙变化导致大多数病例从正确对齐到对齐不良重新分类。CT扫描显示53%的病例对准不良,其中73%接受了手术。
结论：当基于X射线成像的复位后对齐存在疑问时，额外的CT扫描通常会显示对准不良，主要是由于关节内不一致。
