Abstract
Objective
The aim of the study was to analyze the imaging findings of Die-punch fracture of intermediate column of the distal radius, and to explore the clinical application value of image classification.
Methods
The clinical data of 45 patients who were admitted to our hospital from May 2010 to October 2016 were analyzed retrospectively. All patients met the inclusion criteria for Die-punch fracture. X-ray and CT scan were performed to examine the fracture, and the results were assessed by two doctors in a double blind method. Finally, the image classification of Die-punch fracture was formulated.
Results
According to the imaging features of Die-punch fracture, it was divided into four types: type I (dorsal type, 15 cases), type II (volar type, 8 cases), type III (splitting type, 10 cases), type IV (collapsed type, 12 cases). The accuracy rate of CT was 100% (45/45). The misclassification rate of X-ray was 15.6% (7/45) and the missed diagnosis rate was 11.1% (5/45).
Conclusions
CT examination could accurately diagnose Die-punch fracture and perform preoperative image classification.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Nakanishi Y, Omokawa S, Shimizu T (2013) Intra-articular distal radius fractures involving the distal radioulnar joint (DRUJ): three dimensional computed tomography-based classification. J Orthop Sci 18(5):788–792
Xu L, Zhang XZ, Li LM (2008) Open reduction and internal fixation for Die-punch fracture of distal radius. Orthop J China 25(6):1001–1006
Yong-Jie YE, Yang B, Luo B, Yin Y, Chen G (2012) External fixator or locking compression plate for the treatment of Die-punch fractures in distal end of radius. West China Med J 27(8):1157–1161
Sun YQ, Stephen M, Meinhard BP (2001) Surgical treatment of comminuted Die-punch patellar fracture. Orthopedics 24(10):947–950
Brink PR, Rikli DA (2016) Four-corner concept: CT-Based assessment of fracture patterns in distal radius. J Wrist Surg 5(2):147
Oppermann J, Bredow J, Beyer F (2015) Distal radius: anatomical morphometric gender characteristics. Do anatomical pre-shaped plates pay attention on it? Arch Orthop Trauma Surg 135(1):133–139
Vasenius J (2014) Die-punch fractures: open and arthroscopy-assisted fixation:181–187
Wu Y (2014) Surgical treatment of Die-punch fracture of the distal radius. Chin J Orthop Trauma 30(2):121–123
Van ED, Rhemrev SJ, Meylaerts SA, Roukema GR (2010) The comparison of two classifications for trochanteric femur fractures: the AO/ASIF classification and the Jensen classification. Inj int J Care Inj 41(4):377–381
Rayhack JM (1993) The history and evolution of percutaneous pinning of displaced distal radius fractures. Orthop Clin N Am 24(2):287–300
Earp BE, Foster B, Blazar PE (2015) The use of a single volar locking plate for AO C3-type distal radius fractures. HAND 10(4):649–653
Lu Y, Li S, Wang M (2015) A classification and grading system for Barton fractures. Int Orthop 40(8):1–10
Rikli DA, Regazzoni P (1996) Fractures of the distal end of the radius treated by internal fixation and early function A preliminary report of 20 cases. J Bone Jt Surg Brit 78(4):588–592
Meena S, Sharma P, Sambharia AK, Dawar A (2014) Fractures of distal radius: an overview. J Fam Med Prim Care 3(4):325–332
Thomas BP, Sreekanth R (2012) Distal radioulnar joint injuries. Indian J Orthop 46(5):493
Bartl C, Stengel D, Bruckner T, Gebhard F (2014) The treatment of displaced intra-articular distal radius fractures in elderly patients. Deutsches Arzteblatt Int 111(46):779
Nicole N, Bindra RR (2014) Fixation of distal ulna fractures associated with distal radius fractures using intrafocal pin plate. J Wrist Surg 3(1):55–59
Fok MW, Klausmeyer MA, Fernandez DL, Orbay JL, Bergada AL (2013) Volar plate fixation of intra-articular distal radius fractures: a retrospective study. J Wrist Surg 02(03):247–254
Dzaja I, Macdermid JC, Roth J, Grewal R (2013) Functional outcomes and cost estimation for extra-articular and simple intra-articular distal radius fractures treated with open reduction and internal fixation versus closed reduction and percutaneous Kirschner wire fixation. Can J Surg 56(6):378–384
Shukla R, Jain RK, Sharma NK, Kumar R (2014) External fixation versus volar locking plate for displaced intra-articular distal radius fractures: a prospective randomized comparative study of the functional outcomes. J Orthop Traumatol 15(4):265–270
Helmerhorst GT, Kloen P (2012) Orthogonal plating of intra-articular distal radius fractures with an associated radial column fracture via a single volar approach. Inj Int J Care Inj 43(8):1307
Diaz-Garcia RJ, Oda T, Shauver MJ et al (2011) A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg 36(5):824
Kim JK, Sang DP (2013) Outcomes after volar plate fixation of low-grade open and closed distal radius fractures are similar. Clin Orthop Relat Res 471(6):2030–2035
Protopsaltis TS, Ruch DS (2008) Volar approach to distal radius fractures. J Hand Surg 33(33):958–965
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no actual or potential conflicts of interest to declare.
Funding
None.
Ethical approval
All procedures performed in studies involving human participants were approved by the Ethics Committee of Wuxi Hand Surgery Hospital and in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Consent for publication
The study was undertaken with the patient’s consent.
Additional information
Yunhong Ma and Qudong Yin have contributed equally to this work.
Rights and permissions
About this article
Cite this article
Ma, Y., Yin, Q., Rui, Y. et al. Image classification for Die-punch fracture of intermediate column of the distal radius. Radiol med 122, 928–933 (2017). https://doi.org/10.1007/s11547-017-0797-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11547-017-0797-8