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Radiographic interpretation of distal radius fractures: visual estimations versus digital measuring techniques
Michael P O'Malley1, Craig Rodner1, Andrew Ritting1
1Department of Orthopaedic Surgery, University of Connecticut Health Center, MARB Building, 263 Farmington Ave, Farmington, CT 06031 USA.
Hand (New York, N.Y.)
|November 22, 2014
Summary
Visual estimation of distal radius fractures is inaccurate. Radiographic measurements conflict with formal readings, potentially impacting treatment decisions for this common injury.
Area of Science:
- Orthopaedic surgery
- Radiology
- Trauma care
Background:
- Distal radius fractures are frequent injuries encountered in emergency settings.
- Trainees often rely on visual estimation for assessing these fractures.
- Accurate radiographic assessment is crucial for appropriate treatment planning.
Purpose of the Study:
- To evaluate the accuracy of visual estimation of radiographic parameters in distal radius fractures.
- To compare visual assessments by orthopaedic trainees and attendings with formal radiological measurements.
- To determine the impact of visual estimation discrepancies on potential treatment plans.
Main Methods:
- Compared visual estimations by 25 orthopaedic physicians with formal measurements by a musculoskeletal radiologist.
- Analyzed radiographs of patients with distal radius fractures using visual estimation for key parameters.
- Employed statistical analyses including Lin concordance coefficients, Bland Altman plots, and Kappa statistic.
Main Results:
- Poor concordance was found for radial inclination (ρc=0.13), radial height (ρc=0.24), and volar tilt (ρc=0.46).
- Kappa statistic for intra-articular displacement was 0.4.
- Treatment based on visual estimates conflicted with formal readings in 27-38% of cases.
Conclusions:
- Visual estimation is inadequate for evaluating distal radius fractures.
- Physicians must be cautious when basing treatment solely on visual assessment.
- Formal measurements are recommended for accurate diagnosis and treatment planning.
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