CT imaging and typing in Die-punch fractures of the distal radius

Abstract

Objective To explore its imaging types by analyzing CT features of Die-punch fractures of the distal radial in order to provide accurate diagnosis and preoperative guidance. Methods A retrospective analysis was made from January 2009 to August 2015 in 39 cases met the inclusion criteria for Die-punch fractures of the distal radius, all patients' plain radiographs and CT examinations were read by two senior diagnostic radiologists with double blind method. According to imaging findings and therapeutic method, the radiological classification of Die-punch fractures was proposed. Results There were four types for Die-punch fractures of the distal radius based on the CT imaging features. Type Ⅰ: dorsal type in 13 cases. Type Ⅱ: volar type in 7 cases patients with palmar type. Type Ⅲ: slitting type in 8 cases. Type Ⅳ: collapsed type in 11 cases. CT diagnostic accuracy for such fractures was 100.0%; the rate of missed diagnosis by plain radiograph was 10.3% (4/39) with misjudgment misdiagnosis rate of 17.1% (6/35). Conclusions CT scanning was able to provide not only definitive diagnosis and radiological types of distal radial Die-punch fracture, but also an important guiding tool for clinical treatment and choice of surgical approach. Key words: Tomography,X-ray computed; Diagnosis; Radius fractures