MDCT evaluation of distal radius fractures and their association with carpal and distal ulnar fractures

Emerg Radiol. 2023 Oct;30(5):629-635. doi: 10.1007/s10140-023-02169-y. Epub 2023 Sep 1.

Abstract

Purpose: The purpose of this study was to evaluate the characteristics of distal radius fractures (DRFs) in patients undergoing multi-detector computed tomography (MDCT) and their association with carpal and distal ulnar fractures.

Methods: This retrospective study analyzed 120 patients, who underwent MDCT for evaluation of DRFs. Two radiologists independently evaluated the data for various fracture characteristics and for associated carpal and distal ulnar fractures.

Results: Out of 120 DRFs, 74 were complete articular, 40 were partial articular and only 6 were extra-articular. Displacement was present in 99 fractures and intra-articular step off was present in 73 fractures. A total of 81 carpal bone fractures were identified in 46 (38.3%) patients, with more than one carpal bone fracture in 21 patients. Distal ulnar fractures were detected in 79 patients (65.8%), out of which 67 involved the ulnar styloid. DRFs with intra-articular step off were more frequently associated with carpal bone fracture (p value: 0.021), while displaced DRFs were more frequently associated with distal ulnar fracture (p value <0.001). Interobserver agreement for detection of carpal bone fractures (κ = 0.807) and distal ulnar fractures (κ = 0.923) was excellent.

Conclusion: Majority of DRFs in patients referred for MDCT were complete articular with high incidence of displacement and intra-articular step off. Associated carpal bone and distal ulna fractures were not uncommon.

Keywords: Carpal bones; Multidetector computed tomography; Radius fractures; Ulna fractures; Wrist fractures.

MeSH terms

  • Carpal Bones*
  • Fracture Fixation, Internal / methods
  • Humans
  • Radius Fractures* / diagnostic imaging
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ulna Fractures* / diagnostic imaging
  • Wrist Fractures*
  • Wrist Injuries* / diagnostic imaging