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Arch Hand Microsurg > Volume 21(4); 2016 > Article
Journal of the Korean Society for Surgery of the Hand 2016;21(4):205-211.
Published online December 30, 2016.
DOI: https://doi.org/10.12790/jkssh.2016.21.4.205   
Evaluation of the Foveal Involvement of the Ulnar Styloid Fracture: A Comparison of the Plain Radiography and Three-Dimensional Computed Tomography
Jin Woo Kang, Seung Han Shin, Yong Suk Lee, Yong Gyu Sung, Dong Hyun Kim, Do Yeol Kim, Jin Hyung Im, Yang Guk Chung
1Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. ygchung@catholic.ac.kr
2Department of Orthopedic Surgery, Korean Armed Forces Capital Hospital, Seongnam, Korea.
3Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, Bucheon, Korea.
4Department of Orthopedic Surgery, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Received: 1 October 2016   • Revised: 23 October 2016   • Accepted: 23 October 2016
Abstract
Purpose
There remains uncertain whether to fix or not an ulnar styloid fracture acommpanied by distal radius fracture. Fixation might be required in cases of the fracture involving a fovea of ulnar head, an attachment site of deep triangular fibrocartilage, which is thought to be important to distal radioulnar joint stability. We analyzed a fovea involvement of an accompanied ulnar styloid fracture in patients with distal radius fracture by simple radiograph and three-dimensional computed tomography (3D CT).

Methods
We retrospectively reviewed 168 patients who underwent surgery with volar locking plate for distal radius fracture in our hospital from January 2005 to March 2015 and evaluated a fovea involvement of ulnar head by simple radiographs and 3D CT respectively, and compared.

Results
On simple X-ray, 64 cases (38%) were ulnar styloid fovea fractures; however, 21 cases of these revealed non-fovea fractures by 3D CT. And 7 out of 104 cases determined as non-fovea fracture by simple radiographs were diagnosed as fovea fractures by 3D CT. Sensitivity, specificity and accuracy of evaluation by simple radiograph were 86%, 82% and 83% respectively, when compared with those of 3D CT based evaluation.

Conclusion
Accuracy of evaluating an accompanied ulnar styloid fovea fracture in patients with distal radius fracture by simple radiograph, when compared with 3D CT, was 83%; therefore, we recommend using the 3D CT based evaluation instead of simple radiograph based one for determination of fovea involvement of ulnar head.
 
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