Evaluation of the Sigmoid Notch Involvement in the Intra-Articular Distal Radius Fractures: The Efficacy of Computed Tomography Compared with Plain X-ray

Abstract

BackgroundThe purpose of this study is to evaluate the efficacy of computed tomography (CT) scans compared with plain radiographs on detecting the involvement of the sigmoid notch.MethodsThis study involved 121 cases diagnosed as the intra-articular distal radius fracture and performed post-reduction CT scans. We determined the presence of the sigmoid notch involvement with both plain radiographs and CT scans and compared findings of plain radiographs with CT scans about the incidence and the pattern of injuries. And the differences of results between arbeitsgemeinschaft für osteosyntheses (AO) type C2 and C3 were compared.ResultsThe incidences of sigmoid notch involvement detected in plain radiographs were 81 cases (66.9%), whereas CT scans were 99 cases (81.9%). The sensitivity of plain radiographs compared with CT scans was 74.7%, the specificity was 68.2%, the positive predictive value was 91.4%, the negative predictive value was 37.5%, the false negative value was 25.3%, and the false positive value was 31.8%. In comparison between AO type C2 and C3, the incidence of sigmoid notch involvement was not a significant difference, but the displacement of fracture fragment showed a significant difference.ConclusionsThe intra-articular distal radius fracture usually accompanies the sigmoid notch involvement. Considering that the evaluation of sigmoid notch involvement by plain radiography often results in misinterpretation or underestimation, performing CT scan in intra-articular distal radius fracture is thought to be beneficial.

A retrospective, semi-quantitative image quality analysis of cone beam computed tomography (CBCT) and MSCT in the diagnosis of distal radius fractures

“…Multislice CT (MSCT) is superior to conventional radiography in sensitivity for fractures [1,2], assessment of intraarticular fractures [3,4], and in the accuracy of fracture measurements [5,6]. Zbijewski et al [7] identified three factors that limit a broader application of MSCT as an alternative to conventional x-ray imaging in musculoskeletal (MSK) imaging: MSCT imaging does not allow for weight-bearing examinations, applies more radiation dose, is more costly, and has larger spatial demands [7].…”

Classification systems for distal radius fractures

“…( 2001 ) and Heo et al. ( 2012 ) reported that sigmoid notch involvement is underestimated when using only CR. This feature is also seen in our study.…”

Dorsal Lunate Facet Fracture Reduction Using a Bone Reduction Forceps

“…Third, the use of CT scans in all patients to detect dorsal lunate fractures may have overdiagnosed patients. 1,4,32 Fourth, all the measurements were performed by one investigator. Finally, our follow-up limits conclusions regarding osteoarthritic changes of the radiocarpal and DRU joint.…”