Cargando…

Reliability of radiographic measurements for acute distal radius fractures

BACKGROUND: The management of distal radial fractures is guided by the interpretation of radiographic findings. The aim of this investigation was to determine the intra- and inter-observer reliability of eight traditionally reported anatomic radiographic parameters in adults with an acute distal rad...

Descripción completa

Detalles Bibliográficos
Autores principales: Watson, Narelle J., Asadollahi, Saeed, Parrish, Frank, Ridgway, Jacqueline, Tran, Phong, Keating, Jennifer L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957423/
https://www.ncbi.nlm.nih.gov/pubmed/27443373
http://dx.doi.org/10.1186/s12880-016-0147-7
_version_ 1782444181494431744
author Watson, Narelle J.
Asadollahi, Saeed
Parrish, Frank
Ridgway, Jacqueline
Tran, Phong
Keating, Jennifer L.
author_facet Watson, Narelle J.
Asadollahi, Saeed
Parrish, Frank
Ridgway, Jacqueline
Tran, Phong
Keating, Jennifer L.
author_sort Watson, Narelle J.
collection PubMed
description BACKGROUND: The management of distal radial fractures is guided by the interpretation of radiographic findings. The aim of this investigation was to determine the intra- and inter-observer reliability of eight traditionally reported anatomic radiographic parameters in adults with an acute distal radius fracture. METHODS: Five observers participated. All were routinely involved in making treatment decisions based on distal radius fracture radiographs. Observers performed independent repeated measurements on 30 radiographs for eight anatomical parameters: dorsal shift (mm), intra-articular gap (mm), intra-articular step (mm), palmar tilt (degrees), radial angle (degrees), radial height (mm), radial shift (mm), ulnar variance (mm). Intraclass correlation coefficients (ICCs) and the magnitude of retest errors were calculated. RESULTS: Measurement reliability was summarised as high (ICC > 0.80), moderate (0.60–0.80) or low (<0.60). Intra-observer reliability was high for dorsal shift and palmar tilt; moderate for radial angle, radial height, ulnar variance and radial shift; and low for intra-articular gap and step. Inter-observer reliability was high for palmar tilt; moderate for dorsal shift, ulnar variance, radial angle and radial height; and low for radial shift, intra-articular gap and step. Error magnitude (95 % confidence interval) was within 1–2 mm for intra-articular gap and step, 2–4 mm for ulnar variance, 4–6 mm for radial shift, dorsal shift and radial height, and 6–8° for radial angle and palmar tilt. CONCLUSIONS: Based on previous reports of critical values for palmar tilt, ulnar variance and radial angle, error margins appear small enough for measurements to be useful in guiding treatment decisions. Our findings indicate that clinicians cannot reliably measure values ≤1 mm for intra-articular gap and step when interpreting radiographic parameters using the standardised methods investigated in this study. As a guide for treatment selection, palmar tilt, ulnar variance and radial angle measurements may be useful, but intra-articular gap and step appear unreliable. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12880-016-0147-7) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4957423
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-49574232016-07-23 Reliability of radiographic measurements for acute distal radius fractures Watson, Narelle J. Asadollahi, Saeed Parrish, Frank Ridgway, Jacqueline Tran, Phong Keating, Jennifer L. BMC Med Imaging Research Article BACKGROUND: The management of distal radial fractures is guided by the interpretation of radiographic findings. The aim of this investigation was to determine the intra- and inter-observer reliability of eight traditionally reported anatomic radiographic parameters in adults with an acute distal radius fracture. METHODS: Five observers participated. All were routinely involved in making treatment decisions based on distal radius fracture radiographs. Observers performed independent repeated measurements on 30 radiographs for eight anatomical parameters: dorsal shift (mm), intra-articular gap (mm), intra-articular step (mm), palmar tilt (degrees), radial angle (degrees), radial height (mm), radial shift (mm), ulnar variance (mm). Intraclass correlation coefficients (ICCs) and the magnitude of retest errors were calculated. RESULTS: Measurement reliability was summarised as high (ICC > 0.80), moderate (0.60–0.80) or low (<0.60). Intra-observer reliability was high for dorsal shift and palmar tilt; moderate for radial angle, radial height, ulnar variance and radial shift; and low for intra-articular gap and step. Inter-observer reliability was high for palmar tilt; moderate for dorsal shift, ulnar variance, radial angle and radial height; and low for radial shift, intra-articular gap and step. Error magnitude (95 % confidence interval) was within 1–2 mm for intra-articular gap and step, 2–4 mm for ulnar variance, 4–6 mm for radial shift, dorsal shift and radial height, and 6–8° for radial angle and palmar tilt. CONCLUSIONS: Based on previous reports of critical values for palmar tilt, ulnar variance and radial angle, error margins appear small enough for measurements to be useful in guiding treatment decisions. Our findings indicate that clinicians cannot reliably measure values ≤1 mm for intra-articular gap and step when interpreting radiographic parameters using the standardised methods investigated in this study. As a guide for treatment selection, palmar tilt, ulnar variance and radial angle measurements may be useful, but intra-articular gap and step appear unreliable. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12880-016-0147-7) contains supplementary material, which is available to authorized users. BioMed Central 2016-07-22 /pmc/articles/PMC4957423/ /pubmed/27443373 http://dx.doi.org/10.1186/s12880-016-0147-7 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Watson, Narelle J.
Asadollahi, Saeed
Parrish, Frank
Ridgway, Jacqueline
Tran, Phong
Keating, Jennifer L.
Reliability of radiographic measurements for acute distal radius fractures
title Reliability of radiographic measurements for acute distal radius fractures
title_full Reliability of radiographic measurements for acute distal radius fractures
title_fullStr Reliability of radiographic measurements for acute distal radius fractures
title_full_unstemmed Reliability of radiographic measurements for acute distal radius fractures
title_short Reliability of radiographic measurements for acute distal radius fractures
title_sort reliability of radiographic measurements for acute distal radius fractures
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957423/
https://www.ncbi.nlm.nih.gov/pubmed/27443373
http://dx.doi.org/10.1186/s12880-016-0147-7
work_keys_str_mv AT watsonnarellej reliabilityofradiographicmeasurementsforacutedistalradiusfractures
AT asadollahisaeed reliabilityofradiographicmeasurementsforacutedistalradiusfractures
AT parrishfrank reliabilityofradiographicmeasurementsforacutedistalradiusfractures
AT ridgwayjacqueline reliabilityofradiographicmeasurementsforacutedistalradiusfractures
AT tranphong reliabilityofradiographicmeasurementsforacutedistalradiusfractures
AT keatingjenniferl reliabilityofradiographicmeasurementsforacutedistalradiusfractures