Preoperative Computed Tomography Scan in Distal Radius Fractures and the Effect on Preoperative Planning

Abstract

It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs. Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation. Surgeons were initially provided only preoperative radiographs; they were asked for their PA and PFS. Three months later, each surgeon was provided with the same preoperative radiographs as well as a CT scan. They were asked for their PA and PFS and to grade the usefulness of CT for each fracture. The overall probability of having the same PA and PFS between the two presentations was 70.6% and 70.9%, respectively. There was a significant difference in opinion on the usefulness of the CT scan among the surgeons (P < .001). This study suggests that ordering a CT scan for preoperative planning of open reduction internal fixation for an intra-articular DRF does not affect the approach or fixation strategy in the majority of cases, regardless of how useful a CT scan was determined to be by the surgeon. Therapeutic IV.