Computed tomography for the detection of distal radioulnar joint instability fracture: normal variation and reliability of four scoring systems

doi:10.3969/j.issn.2095-4344.0365

Abstract

Abstract:

BACKGROUND: Computed tomography (CT) is the core method for evaluating distal radioulnar joint (DRUJ) facture, including radioulnar line, subluxation ratio, epicenter and radioulnar ratio methods. There is a lack of study on the advantages and disadvantages, accuracy and optimal condition of these four methods.

OBJECTIVE: To evaluate the consistency of radioulnar line, subluxation ratio, epicenter and radioulnar ratio methods in the diagnosis of DRUJ fracture, and to calculate the normal range of motion, so as to provide evidence for the diagnosis of DRUJ fracture.

METHODS: Forty-six patients (92 wrists) with unilateral DRUJ fracture undergoing conservative treatment were included. CT scans of both wrists were conducted, and images were analyzed independently by two physicians using the radioulnar line, subluxation ratio, epicenter and radioulnar ratio methods. The inter- and intra-observer agreement was assessed and normal values were determined based on the uninjured wrists.

RESULTS AND CONCLUSION: Inter- and intra-observer agreement was best for the epicenter method (ICC=0.73 and 0.82). Each method showed a wide normal range for normal DRUJ translation. Normal range for the epicenter method was -0.35 to -0.05 in pronation and -0.12 to 0.20 in supination. These results indicate that DRUJ translation on CT in pro- and supination can be reliably evaluated in both normal and posttraumatic wrists, however with large normal variation. The epicenter method seems most reliable. Scanning of both wrists may be helpful to prevent the radiological over diagnosis of DRUJ instability.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Tissue Engineering, Radius, Ulna

CLC Number:

R318

Wang Xin. Computed tomography for the detection of distal radioulnar joint instability fracture: normal variation and reliability of four scoring systems [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(31): 5009-5014.

Figures/Tables 2

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