Clin Orthop Surg.  2013 Jun;5(2):98-104. 10.4055/cios.2013.5.2.98.

Evaluation of Associated Carpal Bone Fractures in Distal Radial Fractures

• Heo YM
• Kim SB
• Yi JW
• Lee JB
• Park CY
• Yoon JY
• Kim DH

• KMID: 1705529
• DOI: http://doi.org/10.4055/cios.2013.5.2.98

Abstract

BACKGROUND
The purpose of this study was to investigate the frequency and distribution of associated carpal bone fractures (CBFs) in distal radial fractures (DRFs).
METHODS
Three hundred and thirteen patients who underwent surgical treatment for DRFs between March 2007 and January 2010 were reviewed retrospectively. In this study, 223 patients who had preoperative computed tomography (CT) were included. We investigated the frequency and distribution of associated CBFs on CT scans. The relationship between the frequency of associated CBFs and patient factors such as age, gender, body mass index, and the mechanism of injury was assessed.
RESULTS
CBFs were complicated in 46 of 223 DRFs (20.9%). The distribution of CBFs was 23 cases in the triquetrum, 16 in the lunate, 12 in the scaphoid, five in the hamate, and four in the pisiform. Among the 46 cases, a fracture of one carpal bone occurred in 36 cases, two in seven cases, three in two cases, and four in one case. In 10 of the 46 cases, associated CBFs occurred in more than two carpal bones. No significant differences were observed for age, sex, body mass index, or the mechanism of injury between patients with DRFs and CBFs and those without CBFs.
CONCLUSIONS
Because CBFs that mainly occur in the proximal carpal row are complicated in DRFs at a relatively high frequency, assessment of carpal bones using CT scans is beneficial.

Keyword

Distal radius; Carpal bone; Fracture; Frequency

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Carpal Bones/*injuries/radiography
Female
Fractures, Bone/*complications/radiography
Hand Injuries/*complications/radiography
Humans
Male
Middle Aged
Radius Fractures/*complications/radiography
Retrospective Studies
Tomography, X-Ray Computed

Figure

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  Fig. 1 The distribution of carpal bone fractures that occurred simultaneously with distal radial fractures.

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  Fig. 2 Initial radiographs (A and B) show a distal radial fracture (AO type C2) and an ulnar styloid fracture. Reconstructed computed tomography images (C and D) show a palmar pole fracture of the lunate. AO: arbeitsgemeinschaft für osteosyntheses.

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  Fig. 3 Initial radiographs (A and B) show a radial fracture (AO type C3) and an ulnar styloid fracture. A small bony fragment was identified on a lateral radiograph. Reconstructed axial computed tomography image (C) shows a dorsal cortical fracture of the triquetrum and a sagittal fracture of the pisiform. AO: arbeitsgemeinschaft für osteosyntheses.

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  Fig. 4 Initial radiographs (A and B) show a distal radial fracture (AO type C3) and an ulnar styloid fracture. However, no carpal bone fracture is shown on simple radiographs. Reconstructed computed tomography images show fractures of the scaphoid waist (C), palmar pole of the lunate (D), and the hook of the hamate (E). AO: arbeitsgemeinschaft für osteosyntheses.

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  Fig. 5 Initial radiographs (A and B) show a distal radial fracture (AO type C3) and an ulnar styloid fracture. Bony fragments of the distal radial fracture are displaced over the dorsum of the lunate, and a small bony fragment was identified on a lateral radiograph. Reconstructed computed tomography images show a dorsal pole fracture of the scaphoid (C), a cartilage injury of the dorsal pole of the lunate (D), a dorsal cortical fracture of the triquetrum, and a comminuted fracture of the pisiform (E). AO: arbeitsgemeinschaft für osteosyntheses.

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