Distal radius fracture CT: Difference between revisions
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==CT scan== | ==CT scan== | ||
*Although not routinely necessary for most patients with DRFs, CT can be helpful in developing a preoperative surgical plan for patients with complex, multifragmentary fractures. | *Although not routinely necessary for most patients with DRFs, CT can be helpful in developing a preoperative surgical plan for patients with complex, multifragmentary fractures. | ||
*If CT scans are desired, they should be obtained after provisional closed reduction and immobilization to provide an accurate assessment of the displacement of fracture fragments, the articular incongruity, and the magnitude of comminution.<ref name="pmid1549659">{{cite journal| author=Stewart NR, Gilula LA| title=CT of the wrist: a tailored approach. | journal=Radiology | year= 1992 | volume= 183 | issue= 1 | pages= 13-20 | pmid=1549659 | doi=10.1148/radiology.183.1.1549659 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1549659 }} </ref><ref name="pmid3495968">{{cite journal| author=Quinn SF, Murray W, Watkins T, Kloss J| title=CT for determining the results of treatment of fractures of the wrist. | journal=AJR Am J Roentgenol | year= 1987 | volume= 149 | issue= 1 | pages= 109-11 | pmid=3495968 | doi=10.2214/ajr.149.1.109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3495968 }} </ref><ref name="pmid3823428">{{cite journal| author=Biondetti PR, Vannier MW, Gilula LA, Knapp R| title=Wrist: coronal and transaxial CT scanning. | journal=Radiology | year= 1987 | volume= 163 | issue= 1 | pages= 149-51 | pmid=3823428 | doi=10.1148/radiology.163.1.3823428 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3823428 }} </ref> | *If CT scans are desired, they should be obtained after provisional closed reduction and immobilization to provide an accurate assessment of the displacement of fracture fragments, the articular incongruity, and the magnitude of comminution.<ref name="pmid1549659">{{cite journal| author=Stewart NR, Gilula LA| title=CT of the wrist: a tailored approach. | journal=Radiology | year= 1992 | volume= 183 | issue= 1 | pages= 13-20 | pmid=1549659 | doi=10.1148/radiology.183.1.1549659 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1549659 }} </ref><ref name="pmid3495968">{{cite journal| author=Quinn SF, Murray W, Watkins T, Kloss J| title=CT for determining the results of treatment of fractures of the wrist. | journal=AJR Am J Roentgenol | year= 1987 | volume= 149 | issue= 1 | pages= 109-11 | pmid=3495968 | doi=10.2214/ajr.149.1.109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3495968 }} </ref><ref name="pmid3823428">{{cite journal| author=Biondetti PR, Vannier MW, Gilula LA, Knapp R| title=Wrist: coronal and transaxial CT scanning. | journal=Radiology | year= 1987 | volume= 163 | issue= 1 | pages= 149-51 | pmid=3823428 | doi=10.1148/radiology.163.1.3823428 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3823428 }} </ref> | ||
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*Recent literature suggests that evaluating CT examination, imaging in axial and sagittal or axial and coronal planes with 2 mm contiguous sections is usually sufficient. | *Recent literature suggests that evaluating CT examination, imaging in axial and sagittal or axial and coronal planes with 2 mm contiguous sections is usually sufficient. | ||
* CT scan based, the arc method of measurement, are used more reliably for quantifying articular surface incongruities of distal radius than plain radiographic measurements.<ref name="pmid9330135">{{cite journal| author=Cole RJ, Bindra RR, Evanoff BA, Gilula LA, Yamaguchi K, Gelberman RH| title=Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computed tomography. | journal=J Hand Surg Am | year= 1997 | volume= 22 | issue= 5 | pages= 792-800 | pmid=9330135 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9330135 }} </ref> | * CT scan based, the arc method of measurement, are used more reliably for quantifying articular surface incongruities of distal radius than plain radiographic measurements.<ref name="pmid9330135">{{cite journal| author=Cole RJ, Bindra RR, Evanoff BA, Gilula LA, Yamaguchi K, Gelberman RH| title=Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computed tomography. | journal=J Hand Surg Am | year= 1997 | volume= 22 | issue= 5 | pages= 792-800 | pmid=9330135 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9330135 }} </ref> | ||
<gallery> | |||
File:CT scan Wrist dorsal view.JPG|150px|thumb|CT scan Wrist dorsal view. Source: Case courtesy by: [[User:Rohan Bhimani|Dr. Rohan A. Bhimani]]</small> | |||
File:CT scan Lateral View with intraarticular step.JPG|150px|thumb|CT scan lateral view with intraarticular step. Source: Case courtesy by: [[User:Rohan Bhimani|Dr. Rohan A. Bhimani]]</small> | |||
File:CT scan DER VENTRAL.JPG|150px|thumb|CT scan wrist ventral view. Source: Case courtesy by: [[User:Rohan Bhimani|Dr. Rohan A. Bhimani]]</small> | |||
</gallery> | |||
==References== | ==References== | ||
Revision as of 22:43, 11 December 2018
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Distal radius fracture Microchapters |
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Diagnosis |
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Treatment |
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Distal radius fracture CT On the Web |
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American Roentgen Ray Society Images of Distal radius fracture CT |
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Risk calculators and risk factors for Distal radius fracture CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
CT may be useful and can give significant information in comparison with that obtained with conventional radiography in evaluation of complex or occult fractures, distal radial articular surface, distal radio-ulnar joint, ventro-medial fracture fragment assessments of fracture healing as well as post-surgical evaluation.
CT scan
- Although not routinely necessary for most patients with DRFs, CT can be helpful in developing a preoperative surgical plan for patients with complex, multifragmentary fractures.
- If CT scans are desired, they should be obtained after provisional closed reduction and immobilization to provide an accurate assessment of the displacement of fracture fragments, the articular incongruity, and the magnitude of comminution.[1][2][3]
- CT may be indicated for the confirmation of occult fractures suspected on the basis of physical examination, when plain films are normal.
- Knowledge of the thickness of the CT slices can enable to estimate the dimensions and size of each fragment.
- A systematic review of sagittal reformatted CT slices can be beneficial for evaluating the intermediate column fragments and determining both the surgical approach and the type of fixation that may be required.
- Recent literature suggests that evaluating CT examination, imaging in axial and sagittal or axial and coronal planes with 2 mm contiguous sections is usually sufficient.
- CT scan based, the arc method of measurement, are used more reliably for quantifying articular surface incongruities of distal radius than plain radiographic measurements.[4]
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CT scan Wrist dorsal view. Source: Case courtesy by: Dr. Rohan A. Bhimani
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CT scan lateral view with intraarticular step. Source: Case courtesy by: Dr. Rohan A. Bhimani
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CT scan wrist ventral view. Source: Case courtesy by: Dr. Rohan A. Bhimani
References
- ↑ Stewart NR, Gilula LA (1992). "CT of the wrist: a tailored approach". Radiology. 183 (1): 13–20. doi:10.1148/radiology.183.1.1549659. PMID 1549659.
- ↑ Quinn SF, Murray W, Watkins T, Kloss J (1987). "CT for determining the results of treatment of fractures of the wrist". AJR Am J Roentgenol. 149 (1): 109–11. doi:10.2214/ajr.149.1.109. PMID 3495968.
- ↑ Biondetti PR, Vannier MW, Gilula LA, Knapp R (1987). "Wrist: coronal and transaxial CT scanning". Radiology. 163 (1): 149–51. doi:10.1148/radiology.163.1.3823428. PMID 3823428.
- ↑ Cole RJ, Bindra RR, Evanoff BA, Gilula LA, Yamaguchi K, Gelberman RH (1997). "Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computed tomography". J Hand Surg Am. 22 (5): 792–800. PMID 9330135.