Computed tomography evaluation of morphology of distal radius fractures with epiphysical and metaphysical comminution
CT is consitered essential for the precise diagnosis of comminuted intra-articular fractures of the distal radius (FDR). The exact incidence of involvment of the joint surfaces of the distal epiphisys – scaphoid fossa, lunate fossa and sigmoid notch have not been specified so far. This study includes 56 patients with 58 comminuted intra-articular FDR. They were studied by CT. Analysis of frontal, saggital and axial cuts was performed. On axial cuts, involvement of the sigmoid notch was found in 70.68%, a presumably typical fracture line between the scaphoid and lunate fossae was established in only 36.20%, in 43.10% there were depressed fragments of the lunate fossa. On saggital cuts a typical fracture of the lunate fossa was found in nearly 90%, a depressed fragment in the scaphoid fossa – in up to 25% of cases. A fracture line along the crest between the two fossae – found in 40% and a fracture of the scaphoid fossa – simple one in 27%, comminuted in up to 20% has been proven on frontal cuts. CT allows insight in the complex nature of intra-articular FDR. In this study, the incidence of several fracture sub-types – scaphoid fosa involvement, does not entirely follow the classical tenets of FDR pathomechanics.
|Key words: FRACTURE OF THE DISTAL RADIUS. COMPUTER TOMOGRAPHY. SCAPHOID FOSSA, LUNATE FOSSA|