A comparison of 3-D CT and 2-D plain radiograph measurements of the wrist in extra-articular malunited fractures of the distal radius

Camiel J. Smees*, Eline M. van Es, Gabriëlle J.M. Tuijthof, Joost W. Colaris, Feike de Graaff, Anne J.H. Vochteloo

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Two-dimensional (2-D) plain radiographs may be insufficient for the evaluation of distal radial malunion, as it is a three-dimensional (3-D) deformity. This study introduced a 3-D measuring method that outputs radial inclination, ulnar variance, palmar tilt and axial rotation. To this end, a standardized and clearly defined coordinate system was constructed that allowed 3-D measurements closely resembling the conventional 2-D method in 35 patients. Mean differences between 3-D and 2-D measurements in affected wrists were 1.8° for radial inclination, 0.8 mm for ulnar variance and 3.7° for palmar tilt. In addition, inter- and intra-observer reproducibility of all 3-D and 2-D measurements were good or excellent (intraclass correlation coefficient >0.75), with 3-D reproducibility always better than 2-D. Axial rotation was present in all patients with a mean of 7.9° (SD 6.9). Although the differences between 2-D and 3-D measurements were small, 3-D evaluation enables the assessment of axial rotation and brings us closer to a routine 3-D evaluation of malunion.

Original languageEnglish
Number of pages8
JournalJournal of Hand Surgery: European Volume
DOIs
Publication statusE-pub ahead of print/First online - 21 Nov 2023

Keywords

  • UT-Hybrid-D
  • diagnostics
  • palmar tilt
  • Radial inclination
  • radius malunion
  • ulnar length
  • volar tilt
  • axial rotation

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