1. Distal radius fractures and radiographic assessment: a systematic review of measurement accuracy
- Author
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Ole Graumann, Benjamin Schnack Rasmussen, Hans B. Tromborg, Janni Jensen, Helle Precht, Louise Aarup Duus, and Trine Torfing
- Subjects
Accuracy and precision ,radiography and systematic critical review ,Radiography ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Orthodontics ,Radiological and Ultrasound Technology ,accuracy ,business.industry ,Systematic literature review ,Reproducibility of Results ,General Medicine ,Radius ,Wrist Injuries ,respiratory tract diseases ,030220 oncology & carcinogenesis ,Fracture (geology) ,Distal radius fracture ,Radius Fractures ,business - Abstract
Background: Distal radius fracture characterization and treatment are mainly based on radiographic measurements but with contradictory findings on the correlation of those measurements to clinical outcome. Before applying radiographic measurement to the treatment decision and before correlating the measurements to clinical outcome, an accuracy of measurements must be established. Purpose: To summarize existing evidence on accuracy of the radiographic measurements of: (i) dorsal/volar tilt of the distal radius; (ii) radial shortening; (iii) ulnar variance; (iv) radial inclination; and (v) articular step-off of the distal radius. We conducted a systematic critical review of the literature. Material and Methods: MEDLINE, EMBASE, and the Cochrane Library database were searched. The Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines were followed. Quality of included studies was assessed using a tailored version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Results: A total of 5908 publications were screened and five studies met the inclusion criteria. Four studies assessed accuracy of articular step-off but with contradictory outcomes. Radiographic measurements of step-off were accurate in two studies and inaccurate in one study. In the last step-off study, some of their measurements varied significantly but accuracy was not reported. The radiographic measurements of ulnar variance were significantly underestimated when compared to the true variance. We were not able to include studies that assessed accuracy of radial shortening, radial inclination, or dorsal/volar tilt against a reference standard. Conclusion: Currently, evidence is not available to support accuracy of the radiographic measurements commonly used to characterize distal radius fractures.
- Published
- 2019
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