| Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach. | |
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MedLine Citation:
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PMID: 20721718 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopyguided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. METHODS: A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. RESULTS: Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of > or = 2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. CONCLUSIONS: Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after internal fixation. |
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Authors:
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Hiroshi Ono; Kazuhiko Furuta; Ryotaro Fujitani; Takeshi Katayama; Manabu Akahane |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2010-08-19 |
Journal Detail:
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Title: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association Volume: 15 ISSN: 1436-2023 ISO Abbreviation: J Orthop Sci Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-08-19 Completed Date: 2010-12-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9604934 Medline TA: J Orthop Sci Country: Japan |
Other Details:
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Languages: eng Pagination: 502-8 Citation Subset: IM |
Affiliation:
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Department of Orthopaedic Surgery, Kokuho Central Hospital, 404-1 Miyako Tawaramoto, Nara 636-0302, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Arthroscopy / methods* Female Fluoroscopy Fracture Fixation, Internal / methods* Humans Image Interpretation, Computer-Assisted Male Middle Aged Prospective Studies Radius Fractures / radiography*, surgery* Sensitivity and Specificity Tomography, X-Ray Computed Trauma Severity Indices* Volar Plate / radiography, surgery* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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