Diagnostic Failure Rate in Detecting Perilunate Carpal Fractures and Dislocations Using Plain Wrist X-Rays

• Published in: Revista brasileira de ortopedia Vol. 56; no. 3; pp. 340 - 345
• Main Authors: Tanure, Aleixo Abreu, de Andrade, Fernanda Ruiz, Rezende, Luis Guilherme Rosifini Alves, Cagnolati, Amanda Favaro, Mandarano-Filho, Luiz Garcia, Mazzer, Nilton
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-06-2021; Sociedade Brasileira de Ortopedia e Traumatologia
• Subjects: Artigos Originais; carpal bones/injuries; fractures, bone; joint dislocations; ORTHOPEDICS; wrist injuries; traumatismos do punho; fractures, bone; wrist injuries; joint dislocations; ossos do carpo/lesões; fraturas ósseas; carpal bones/injuries; luxações articulares
• ISSN: 0102-3616; 1982-4378; 1982-4378
• DOI: 10.1055/s-0040-1714227

Objectives
 The present study aimed to evaluate the diagnostic failure rate in detecting perilunate fractures and dislocations using plain wrist radiographs by orthopedists and orthopedic residents. A secondary objective was to identify possible groups with a greater or lesser chance of establishing a correct diagnosis.
Methods
 An online questionnaire was sent to several orthopedists through e-mail, social networks, and smartphone-based communication applications to assess the rate of diagnostic failure in detecting perilunate fractures and dislocations using plain radiographs.
Results
 A total of 511 responses was obtained, with a diagnostic error rate of 8.81% for simple dislocations and 1.76% for trans-scaphoid perilunate fractures. Group stratification showed that residents presented the highest error rates in simple perilunate dislocations (23.91%), whereas hand surgeons presented the lowest error rates (1.74%).
Conclusion
 Compared with the literature, the failure rates found were lower, suggesting that plain radiography is effective and that the error rate may not be as high as reported.