ROLE OF TRACTION RADIOGRAPHS VERSUS STANDARD RADIOGRAPHS IN DIAGNOSING AND MANAGING DISTAL RADIUS FRACTURES

Abstract

Objective: To compare standard radiographs with traction radiographs against CT for diagnosing intra-articular distal radius fractures and guiding management.
Study Design: A validation study.
Place and Duration of Study: Shaheed Mohtarma Benazir Bhutto Institute of Trauma (SMBBIT), Karachi, over a 3-month period.
Methodology: A total of 170 patients with acute closed distal radius fractures were included after ethical approval. All patients received standard radiographs (SR), traction radiographs (TR) and CT (gold standard). Diagnostic indices, Cohen’s kappa and McNemar test were applied.
Results: CT confirmed intra-articular involvement in 94/170 (55.3%) patients. Sensitivity, specificity and accuracy for SR were 73.4%, 68.4% and 71.2% versus 89.4%, 80.3% and 85.3% for TR, respectively. TR had stronger agreement with CT (kappa = 0.701 vs. 0.418) and significantly higher paired correctness than SR (McNemar p = 0.001). Management concordance was 78.2% for SR and 88.8% for TR (p = 0.018).
Conclusion: Traction radiographs improved diagnostic accuracy and management concordance compared with standard radiographs alone for distal radius fractures.