Improved precision of radiographic measurements for distal radius fractures after a technique-teaching tutorial

Fox, Shandy; Johnston, Geoffrey; Stewart, Samuel Alan

doi:10.1503/cjs.001419

Cited by 6 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, an error of ≤2° in dorsopalmar tilt measurements using manual landmarking seems unreachable regardless of the condition of the radius. However, this acceptability criterion of 2° 16 should be considered in relation to other studies suggesting that a residual deformity within 10° might also be acceptable 14 . The assessment of a 10° error is influenced by both the precision of the measurements and the potential impact of interobserver reproducibility on the models.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

An Evaluation of the Reliability of Manual Landmark Identification on 3D Segmented Wrists

Winter,

Citarel,

Chabrand

et al. 2023

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

Background: Three-dimensional (3D) preoperative planning is increasingly used in orthopaedic surgery. Two-dimensional (2D) characterization of distal radial deformities remains inaccurate, and 3D planning requires a reliable reference frame at the wrist. We aim to evaluate the reliability of the determination of anatomical points placed manually on 3D models of the radius to determine which of those points allow reliable morphometric measurements. Methods: Twenty-three radial scans were reconstructed in 3D. Five operators specialized in the upper limb manually positioned 8 anatomical points on each model. One of the operators repeated the operation 6 times. The anatomical points were based on previously published 3D models used for radial inclination and dorsopalmar tilt measurements. The repeatability and reproducibility of the measurements derived using this manual landmarking were calculated using different measurement methods based on the identified points. An error of ≤2° was considered clinically acceptable. Results: This study of intraobserver and interobserver variability of the anatomic points allowed us to determine the least variable and most accurately defined points. The middle of the ulnar border of the radius, the radial styloid, and the midpoint of the ulnar incisura of the radius were the least variable. The palmar and dorsal ends of the ridge delineating the scaphoid and lunate facets were the most variable. Only 1 of the radial inclination measurement methods was clinically acceptable; the others had a repeatability and reproducibility limit of >2°, making those measurements clinically unacceptable. Conclusions: The use of isolated points seems insufficient for the development of a wrist reference frame, especially for the purpose of measuring dorsopalmar tilt. If one concurs that an error of 2° is unacceptable for all distal radial measurements, then clinicians should avoid using 3D landmarked points, due to their unreliability, except for radial inclination measured using the radial styloid and the midpoint of the ulnar edge of the radius. A characterization of the wrist using 3D shapes that fit the articular surface of the radius should be considered. Level of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract

Section: Discussionmentioning

confidence: 97%

“…Modified Bland-Altman plots showing the deviations of the measurement from the mean were computed. According to the literature, the measurements were considered clinically reliable if the reproducibility limit (2SR, described below) was ≤2° 16 .…”

Section: Methodsmentioning

confidence: 99%

An Evaluation of the Reliability of Manual Landmark Identification on 3D Segmented Wrists

Winter,

Citarel,

Chabrand

et al. 2023

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

“…Using online tools (Intellispace; Phillips, UK), five measurements were made on both groups of radiographs, all by a fellowship-trained orthopaedic hand and wrist surgeon (GHFJ; Figure 3). These were: radial inclination (RI) in degrees, 18 and four linear measurements in mm from lines perpendicular to reference axes of the distal radial (DRS) and distal ulnar (DUS) shafts. These axes were drawn as best representative of their distal axes from the PA radiographs, rather than as best averages of mid- and distal shafts.…”

Section: Methodsmentioning

confidence: 99%

Coronal translation of the forearm, proximal capitate, and ulnar styloid predict radial inclination in distal radius fractures in older female patients

et al. 2023

View full text Add to dashboard Cite

AimsThe aims of this study were to identify means to quantify coronal plane displacement associated with distal radius fractures (DRFs), and to understand their relationship to radial inclination (RI).MethodsFrom posteroanterior digital radiographs of healed DRFs in 398 female patients aged 70 years or older, and 32 unfractured control wrists, the relationships of RI, quantifiably, to four linear measurements made perpendicular to reference distal radial shaft (DRS) and ulnar shaft (DUS) axes were analyzed: 1) DRS to radial aspect of ulnar head (DRS-U); 2) DUS to volar-ulnar corner of distal radius (DUS-R); 3) DRS to proximal capitate (DRS-PC); and 4) DRS to DUS (interaxis distance, IAD); and, qualitatively, to the distal ulnar fracture, and its intersection with the DUS axis.ResultsIn the study (fracture) and control groups, respectively, the mean values were: RI, 17.2° (SD 7.2°; -7° to 35°) and 25.6° (SD 2.6°; 21° to 30°); DRS-U, 13.5 mm (SD 1.7; 4.9 to 20.8) and 15.3 mm (SD 0.72; 13.8 to 16.3); DUS-R, 13.4 mm (SD 2.1; 4.8 to 18.5) and 12.0 mm (SD 0.99; 9.7 to 13.9); DRS-PC (positive value radial to DRS, negative value ulnar), 0.14 mm (SD 5.4; -10.9 to 22.7) and -6.1 mm (SD 1.6; -10.6 to -2.3); and IAD, 25.3 mm (SD 2.5; 17.6 to 31.1) and 27.1 mm (SD 1.5; 24.5 to 31.0). All means were significantly different between the study and control groups. RI correlated strongly with DRS-PC. Ulnar styloid fracture intersection with the DUS axis, reflective of ulnar translation of both radial and ulnar shafts, was associated with significantly lower RI.ConclusionAfter DRF, the relationship of the proximal capitate to the DRS axis in the coronal plane correlates with the final radial inclination. Additionally, ulnar styloid intersection with the DUS axis is associated with even lower radial inclination. DRF reduction should seek to restore the normal coronal relationship of both radial and ulnar shafts to their distal counterparts.Cite this article: Bone Joint J 2023;105-B(6):688–695.

show abstract

Magnitude, Direction, Temporal Patterns, and Frequency of Loss of Distal Radius Fracture Reduction in Women 50 Years and Older

Sims

Johnston²,

Cheng

et al. 2022

The Journal of Hand Surgery

View full text Add to dashboard Cite

Improved precision of radiographic measurements for distal radius fractures after a technique-teaching tutorial

Cited by 6 publications

References 30 publications

An Evaluation of the Reliability of Manual Landmark Identification on 3D Segmented Wrists

An Evaluation of the Reliability of Manual Landmark Identification on 3D Segmented Wrists

Coronal translation of the forearm, proximal capitate, and ulnar styloid predict radial inclination in distal radius fractures in older female patients

Magnitude, Direction, Temporal Patterns, and Frequency of Loss of Distal Radius Fracture Reduction in Women 50 Years and Older

Contact Info

Product

Resources

About