Fracture lines and comminution zones in OTA/AO type 23C3 distal radius fractures: The distal radius map

Mısır, Abdülhamit; Öztürk, Kahraman; Kızkapan, Turan Bilge; Yıldız, Kadir İlker; Gur, Volkan; Sevencan, Ahmet

doi:10.1177/2309499017754107

Cited by 22 publications

(17 citation statements)

References 19 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Fracture mapping is an imaging method used to examine fracture characteristics and morphology [7]. It allows for the quantitative evaluation of fractures based on CT images and has already been used for investigating scapular fractures, Hoffa fractures and distal radius fractures [7][8][9][10]. The aim of this study is to use fracture mapping on distal radius fractures of AO/OTA type 23C3 and test the null hypothesis that fracture fragments can be divided according to Melone's classification (shaft, radial styloid, the dorsal medial fragment, and volar medial fragment) [5].Given the limited information available on the anatomical patterns of articular comminution in C3 fractures, this study also aimed to introduce heat mapping of fracture lines to evaluate the morphology of comminuted distal radius fractures.…”

Section: Introductionmentioning

confidence: 99%

Melone’s concept revisited in comminuted distal radius fractures: the three-dimensional CT mapping

Zhang

Wang

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background: There is no consensus in the literature about the ideal classification of the distal radius fracture for the clinical practice. The traditional Melone classification system divides the distal radius into four basic components, the shaft, radial styloid, dorsal medial fragment, and volar medial fragment. The aim of this study was to identify fracture lines in comminuted distal radius fractures using three-dimensional mapping of computed tomography (CT) images to test the hypothesis that fracture fragments can be divided according to the Melone classification. Methods: Fifty-nine consecutive OTA/AO 23C3 fractures presented at the hospital between January 2018 and October 2019 were retrospectively reviewed. The fracture lines were characterized in the axial, sagittal, and coronal CT planes. After reducing the fractures in a three-dimensional (3D) model, the fracture lines were plotted from the CT images and were then superimposed on one another and oriented to fit a standard template. The area of articular surfaces was measured and compared to quantify the differences between the radial bone fragments. Results: Thirty-five cases (59.3%) in this study fit the Melone classification and 24 cases (40.7%) did not. On the radiocarpal surface, there was a greater concentration of fracture lines in the dorsal area of the radius than in the volar area. On the distal radioulnar joint (DRUJ), the fracture lines were focused around two specific concentrated regions. For the articular surface area, the mean area of the radial styloid, volar medial fragment, and dorsal medial fragment was 141.13 ± 90.16 mm 2 , 147.79 ± 75.94 mm 2 , and 79.05 ± 70.73 mm 2 , respectively. There was a significant difference in articular surface area for the Melone fragments (P = 0.002). Conclusions: The Melone classification system is not suitable for characterizing all C3 fractures. The findings of this study confirm that the dorsal medial fragments are relatively comminuted and small. Extra care should be given to these small fragments when reducing the fracture.

show abstract

Section: Introductionmentioning

confidence: 99%

Melone’s concept revisited in comminuted distal radius fractures: the three-dimensional CT mapping

Zhang

Wang

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…The fracture mapping technique described by Cole et al 14 was applied in this study to evaluate the fracture patterns of AO/OTA 34 C3 multifragmentary patellar fractures. To the best of our knowledge, this technique has been used to identify the fracture patterns of complex articular fractures, including scapular fractures 15 , pilon fractures 14 , tibial plateau fractures 16,17 , posterior malleolar ankle fractures 18 , Hoffa fractures 19 , distal radius fractures 20 , and quadrilateral plate fractures 21 . However, this is the rst study to analyze the articular fracture patterns systemically in the coronal and sagittal views to improve the understanding of complex articular injuries of the patella.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Multifragmentary Patellar Fractures: Three-dimensional Computed Tomography-based Fracture Mapping Study

Cho

Yang

Lim

et al. 2021

Preprint

View full text Add to dashboard Cite

Limited literature is available regarding anatomic patterns of articular injuries in comminuted patellar fractures. The present study aimed to map the location and frequency of fracture lines on the coronal and sagittal planes of the articular surface in AO/OTA 34C3 fractures. The directions of the fracture lines from the CT scans of 66 multifragmentary patellar fractures were highlighted in the coronal plane of the articular surface and in the midsagittal plane. The images of all fractures were then oriented to fit and superimposed over a single template. The primary horizontal fracture lines were identified in 63 patients (95.4%) using coronal articular surface fracture mapping. The average value of the primary horizontal fracture line was located between the middle and inferior facets. The secondary horizontal fracture lines ran frequently on the inferior border of the articular facet (83.3%). The secondary vertical fracture lines created satellite fragments and were mostly located on the periphery of the bilateral facet. Sagittal fracture mapping of the primary and secondary horizontal fracture lines with the main coronal fracture line revealed a predominantly X-shaped fracture map. The presence of the free articular type of coronal split fragment was significantly related to inferior pole fractures (OR: 8.15, P = 0.01).

show abstract

“…In this regard, several surgeons said that fracture MT could optimize preoperative planning, such as surgical approach and setting specificity fixation structure [8], [10], [11], [14], [15], [16], [17], [18], [19] , [20], [21]. Others said that the understanding of fracture patterns through the MT of fractures leads to the possibility of the development of new classifications and implant designs [22]. Many others thought that two-dimensional or three-dimensional fracture MT can illustrate the characteristics of fracture distribution and help surgeons predict specific types of fracture injuries (n=9, 32.14%), and lastly some found that MT can also predict the number of fracture lines and the direction of fracture lines, which may have a certain impact on treatment [23].…”

Section: Data Synthesismentioning

confidence: 99%

Translational Medicine: What Orthopaedic Perspectives and Challenges Does the Mapping Technology?

Guang

Wei

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Translational medicine (TM) is a bridge between basic science and clinical medicine by translating new knowledge, mechanisms and technologies generated by basic science research into new ways of preventing, diagnosing and treating disease. The purpose of this study is to systematically review the literature concerning the two-dimensional and three-dimensional mapping technology (MT) for fractures in orthopedics, to clarify what perspectives MT offers and the current challenges in TM. Methods A systematic review was conducted according to PRISMA guidelines. We systematically searched the PubMed, Scopus, IEEE Digital Library, Web of Science database and references of relevant studies, from the establishment of the database through December 2020, for any and all data regarding the application of fracture MT in orthopedics, (including upper limbs, lower limbs, spine, and pelvis). We then made a systematic summary of these research results. Results A total of 2777 articles were retrieved, and 28 articles met the inclusion criteria: 26 were retrospective studies of using fracture MT and 2 were prospective studies using of fracture MT. The application of fracture MT in orthopaedics was as follows: upper limbs (n=10, 35.71%), lower limbs (n=17, 60.71%), thoracolumbar spine (n=1, 3.58%). Article subjects included: how fracture mapping guided preoperative planning (n = 12, 42.86%); illustration of how the characteristics of fracture line distribution helped surgeons identify specific types of fractures (n=9, 32.14%); and how fracture MT illustrated fracture morphology and guided clinical treatment (n=7, 25.00%). Conclusion Today, we need a new generation of researchers: 'translational scientists' who are able to transfer ideas from basic research to clinical science. MT is a better technology to describe the morphological classifications of fractures compared to traditional methods, but its clinical application is still limited. Thus, much further research is needed to determine the potential advantages of this new technique in clinical application or practice. If possible, guidelines are needed to facilitate the development of MT with regard to the additional costs and time constraints required for the developing this technic.

show abstract

Fracture lines and comminution zones in OTA/AO type 23C3 distal radius fractures: The distal radius map

Cited by 22 publications

References 19 publications

Melone’s concept revisited in comminuted distal radius fractures: the three-dimensional CT mapping

Melone’s concept revisited in comminuted distal radius fractures: the three-dimensional CT mapping

Characteristics of Multifragmentary Patellar Fractures: Three-dimensional Computed Tomography-based Fracture Mapping Study

Translational Medicine: What Orthopaedic Perspectives and Challenges Does the Mapping Technology?

Contact Info

Product

Resources

About