Three-dimensional computed tomography mapping and morphological study of distal radius fracture (OTA/AO types 23B and...

Distal radius fractures of OTA/AO types 23B and 23C have a high incidence, and inadequate treatment can lead to complications such as traumatic arthritis, joint pain, and limited wrist function. This study aimed to utilize three-dimensional computed tomography (3D-CT) reconstruction technology and fracture line mapping frequency charts to intuitively and clearly describe the morphological characteristics of distal radius fractures (OTA/AO types 23B and 23C), thereby deepening the understanding of such fractures and providing reference information for this clinical condition.

Patients with OTA/AO types 23B and 23C distal radial fractures who met the inclusion criteria at our hospital were retrospectively analyzed. A three-dimensional model of the fracture was established using CT scans. The articular surface fracture model and the articular depression area were superimposed on the standard model, and the fracture line map, frequency map, and articular depression map were generated.

This study included 212 patients, comprising 67 males and 145 females. There were 104 left-hand fractures and 108 right-hand fractures. The mean age of the enrolled patients was 59.71 ± 13.21 years, ranging from 18 to 88. In terms of injury mechanisms, 172 (81.13 %) resulted from falls, 17 (8.02 %) from falls from height, 12 (5.66 %) from accidents, and 11 (5.19 %) from other factors. The main fracture lines and areas of high fracture frequency were located in the lunate fossa, scaphoid fossa, and its dorsal region. In the fracture frequency map, the high-frequency fracture area exhibited a clear "+" shape pattern, particularly in the dorsal and central regions of the scaphoid fossa, where the fracture involvement frequencies reached 76 % and 67 %, respectively. Conversely, the four corners of the nine segments of the articular surface of the distal radius were less frequently involved, with frequencies in the radial volar and ulnar volar regions at 18 % and 26 %, respectively. Compared to the palmar side, the dorsal side showed more depressions. The depressed area was the most frequently involved part, notably located in the center and dorsal area of the lunate fossa and scaphoid fossa.

The intra-articular fracture line map, frequency map, and articular depression map of the distal radius were created to reveal the morphological distribution characteristics of fracture lines of types 23B and 23C in the OA classification, allowing for the intuitive identification of prone fracture sites, which may aid clinical diagnosis and surgical guidance.