Intraoperative assessment by extended tangential view radiography for reduction of radial sigmoid notch/distal radioulnar joint in distal radius fractures
10.3760/cma.j.cn115530-20240918-00377
- VernacularTitle:腕背伸切线位透视在桡骨远端骨折术中对桡骨乙状窝和下尺桡关节复位情况的评估效果分析
- Author:
Siyuan QING
1
;
Kaoliang QIAN
;
Xiaodong QIN
;
Yu ZHANG
Author Information
1. 中国药科大学附属浦口中医院骨伤科，南京 211800
- Publication Type:Journal Article
- Keywords:
Radius fractures;
Fluoroscopy;
Image processing, computer-assisted;
Distal radioulnar joint
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(7):593-598
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the extended tangential view (ETV) radiography in intraoperative evaluation of reduction of radial sigmoid notch (RSN) and distal radioulnar joint (DRUJ) in distal radius fractures.Methods:A retrospective study was conducted to analyze the data of 25 patients with distal radius fracture who had undergone surgery with a volar locking plate at Department of Orthopaedics, The First Hospital Affiliated to Nanjing Medical University from March 2023 to January 2024. There were 9 males and 16 females, aged 57.0 (49.0, 61.0) years. In all patients, intraoperative ETV radiography and postoperative CT scanning were performed to assess the reduction quality of RSN and DRUJ. The minimum distance from the ulnar screw to the RSN was also measured on intraoperative ETV and postoperative CT axial slices. The differences between the measurements by the 2 methods were calculated. The correlation and consistency of the 2 measurements were assessed by Pearson correlation analysis and plotting of the Bland-Altman diagram. At the last follow-up, the wrist function was evaluated by Gartland-Werley scoring.Results:All patients were followed up for 15.0 (12.0, 19.0) months. Postoperative CT scans detected no screw penetration through the DRUJ in any patient. Of the 18 patients with intra-articular fracture, 15 had RSN and DRUJ injury. Evaluations of reduction of RSN and DRUJ were completely consistent between ETV and CT, yielding 11 excellent, 2 good and 2 poor cases. The minimum distance from the ulnar screw to the RSN was (6.37±2.79) mm by ETV radiography and (4.22±2.06) mm by the postoperative CT scan, showing a difference of (2.15±1.24) mm. The Pearson correlation coefficient was 0.913, indicating a strong correlation between the 2 measurements (95% CI: 1.63 to 2.66, P < 0.05). The scatter data in the Bland-Altman diagram mostly fell within the consistency interval, indicating good consistency. At the last follow-up, all patients had a Gartland Welley score of 1.0 (1.0, 3.0), ranging from 0 to 5 points; 15 cases were excellent and 10 cases were good. Conclusion:As ETV radiography is similar to CT scanning in evaluation of reduction quality of RSN and DRUJ and the invasion of ulnar screw into DRUJ, it has a good application prospect.
