Comparison of three dimensional and radiographic measurements in the analysis of distal radius malunion

• Published in: The Journal of hand surgery, European volume Vol. 38; no. 2; pp. 133 - 143
• Main Authors: Miyake, J., Murase, T., Yamanaka, Y., Moritomo, H., Sugamoto, K., Yoshikawa, H.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-02-2013
• Subjects: Adolescent; Adult; Aged; Chi-Square Distribution; Female; Fracture Fixation - methods; Fractures, Malunited - diagnostic imaging; Fractures, Malunited - therapy; Humans; Imaging, Three-Dimensional - methods; Male; Middle Aged; Radiographic Image Interpretation, Computer-Assisted; Radius Fractures - diagnostic imaging; Radius Fractures - therapy; Regression Analysis; Reproducibility of Results; Tomography, X-Ray Computed - methods; Treatment Outcome; dorsal tilt; three-dimensional analysis; Distal radius malunion; ulnar variance; radial angle
• ISSN: 1753-1934; 2043-6289
• DOI: 10.1177/1753193412451383

To estimate the accuracy of radiographic deformity evaluation for distal radius malunion, we compared the results obtained from radiographic measurements (palmar tilt, radial angle, and ulnar variance) with those from the three-dimensional (3D) method using computer bone models in 20 dorsally tilted malunions. Dorsal tilt deformity, radial tilt deformity, and shortening deformity were calculated using the unaffected side as a reference. The 3D method showed a slightly lower value for dorsal tilt deformity than the radiographic evaluation, but the difference was < 10° in all cases. In patients with dorsal tilt ≥ 40°, notable differences in radial tilt evaluation were observed between the two methods compared with patients with less dorsal tilt. The 3D shortening showed positive correlations with radiographic evaluation, but a discrepancy of ≥ 2 mm was observed in eight cases. Palmar tilt is reliable for surgical planning, but radial angle and ulnar variance may be less accurate than previously thought.