Advantages of CT Imaging in the Evaluation and Management of Distal Radius Fractures

Abstract Purpose To evaluate the importance of computed tomography (CT) in the assessment of distal radius fractures. Methods Fifty distal radius fractures were randomly included in this study. In the first part, preoperative CT images were reconstructed for all patients. After reconstructing the bony structures, 50 fracture lines were plotted on standardized bony structures of the distal radius using 3-matic software. A heat map was created based on the frequency of fracture lines to investigate the overall distribution of distal radius fractures through CT image superimposition. In the second part, all patients' imaging data, including preoperative and postoperative X-rays, were compared with preoperative and postoperative CT scans. Two independent observers analyzed the data to compare the disclosure of important details and to investigate the significance of CT for individual distal radius fractures. Results The overall pattern of fracture lines in distal radius fractures is clearly demonstrated by CT. In the distal radial epiphyseal region, an annular band with a width of 4.52 mm is located in the area of primitive epiphyseal cartilage development below the watershed. Fractures below this annular band were rare. The distribution of volar fracture lines above the annular band was significantly less than that of dorsal fracture lines, which were more concentrated around Lister's tubercle and more frequently involved the distal radial joint. For individuals, preoperative CT and reconstruction techniques revealed 100% of the fracture details, especially in assessing articular surfaces. Postoperative CT provided a more accurate assessment of distal radius fracture repositioning and fixation, such as screw implantation and penetration, and articular surface flattening. However, overall fracture parameters (radial styloid height, radial inclination, palmar tilt) were measured more clearly by X-ray than by CT. Conclusions CT and X-rays are essential for both preoperative and postoperative evaluations of distal radius fractures. However, CT offers a more detailed understanding of fracture characteristics and serves as a more effective guide for preoperative assessment and postoperative monitoring. Therefore, CT should be used as a routine examination.