Do Traction Radiographs of Distal Radial Fractures Influence Fracture Characterization and Treatment?

Abstract

The addition of traction radiographs appeared to affect surgeons' interobserver reliability in the evaluation of distal radial fractures. In addition, traction radiographs changed the rate of detection of intra-articular fragments requiring reduction and the perceived need for computed tomography. These data indicate that traction radiographs may provide some of the same information as computed tomographic scans at a lower cost and argue for additional research comparing computed tomographic scans and traction radiographs of the distal part of the radius.

Distal Radial Traction Radiographs: Interobserver and Intraobserver Reliability Compared with Computed Tomography

“…In light of today's current health-care climate, the decrease in the cost of traction radiographs compared with CT imaging is another benefit. The cost of CT imaging at our institution is >300% of that of a five-view traction series, performed by a radiologist without the use of anesthesia, which is similar to other reports 18 .…”

“…Traction radiographs demonstrate the dynamic nature of the fracture, as well as its ability to become aligned or reduced by ligamentotaxis, and help to remove some overlap of comminuted fracture fragments. As was previously suggested by Goldwyn et al 18 , understanding the dynamic nature of the fracture and the ability of the attached ligamentous structures to hold alignment may change treatment away from extensile approaches.…”

“…Goldwyn et al 18 showed that traction radiographs could provide additional information to increase the interobserver agreement with regard to fracture characteristics and possibly decrease the need for CT imaging. We provided additional support for traction radiographs and the decreased need for CT evaluation.…”

“…Recently Goldwyn et al 18 showed that anteroposterior and lateral traction radiographs in addition to injury and splint radiographs could increase the interobserver reliability of fracture characterization and treatment. A limitation of their study, however, was a lack of a CT comparison group.…”

Statistical analysis on the concordance of the radiological evaluation of fractures of the distal radius subjected to traction

“…Radiography performed under traction is among the other options of lower cost and greater practicality, and this may increase the reliability of analyses on joint fractures. 12 …”