Radiography-computed tomography concordance study of distal radius fractures
Keywords:
radius fractures, X-ray computed tomography, bone scan, osteosynthesis of fractures, reproducibility of the results.Abstract
Introduction: Distal radius fracture is common in the upper extremity and represents a therapeutic challenge.
Objective: To determine the agreement between simple radiography and computed tomography with respect to AO Foundation and Fernández classifications, and the choice of treatment.
Methods: A diagnostic agreement study was carried out between simple radiography and computed tomography. Orthopedists and hand surgeons analyzed 19 images of distal radius fractures according to AO Foundation and Fernández classifications, and the different treatment options. Fleiss Kappa coefficient was used for the degree of agreement. The Student's t-test and chi-square differentiated the groups for quantitative and qualitative variables, respectively. There was a statistical significance of p = 0.05.
Results: Fernández classification coincided better than AO Foundation between radiography and computed tomography. In the choice of treatment and osteosynthesis technique, agreement was greater than 90%, while the surgical approach only reached 50%. The radiographic AO Foundation classification corresponded to complex fractures while Fernández classification corresponded to less complicated ones. Fractures were underestimated when classified with radiography.
Conclusions: The relationship of classifications between radiography and computed tomography for distal radius fractures is not satisfactory. Computed tomography provides information that modifies treatment decisions.
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References
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