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[Special aspects of fractures of the distal forearm].

Der Radiologe 2020 May 9
BACKGROUND: Fractures of the distal forearm, especially fractures of the distal radius which are the most common fracture in humans, are of increasing socioeconomic relevance due to the increasing incidence and the increasing costs that are associated with the popularity of palmar plating.

OBJECTIVES: Radiological imaging for diagnosis and follow-up are presented with special focus on new biomechanical fracture concepts such as the four-corner concept.

MATERIALS AND METHODS: The basic literature and expert opinions are evaluated and discussed.

RESULTS: In intra-articular fractures of the distal radius, plain radiographs must be supplemented by computed tomography (CT). Direct CT arthrography allows not only analysis of the fracture pattern, but also detection of accompanying injuries of the carpus, especially the scapholunate ligament, and the ulnocarpal complex. The plain radiographs should also be analyzed for accompanying injuries. Therefore, both acquisition of the imaging data and their morphometrical analysis have to be standardized.

CONCLUSIONS: In addition to diagnosis and follow-up, radiological imaging plays a decisive role in the treatment of distal forearm fractures. CT and direct CT arthrography have become important tools in intra-articular distal radius fractures.

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