We are pleased to share with you a recent publication in Strategies in Trauma and Limb Reconstruction. This publication is entitled "Can Experienced Surgeons Predict the Additional value of a CT Scan in Patients with Displaced Intra-articular Distal Radius Fractures. "
Please find access to the full-version of the article click here.
Kleinlugtenbelt YV, Madden K, Groen SJ, Ham MD, Kloen P, Haverlag R, Simons MP, Bhandari M, Goslings JC, Scholtes VAB, Poolman RW. Can experienced surgeons predict the additional value of a CT scan in patients with displaced intra-articular distal radius fractures? Strategies Trauma Limb Recon. 2017 Apr [Epub].
There are no clear guidelines when an additional CT scan should be obtained for the treatment of displaced intra-articular distal radius fractures (DRF). This study aimed to investigate whether surgeons can predict the usefulness of CT scans to facilitate choice of treatment plan and/or pre-operative planning for DRF.
Four surgeons evaluated 51 patients with displaced DRF. The choice of treatment (operative or nonoperative) was based on conventional radiographs. Subsequently, the surgeons were asked whether they would have requested an additional CT scan to determine this treatment choice, and also whether they required a CT scan for pre-operative planning.
After 4 weeks, the additional CT scan was provided and the cases were assessed again. Based on these data, we calculated the number needed to scan (NNS) and number needed to harm (NNH) for two decision models. Model 1: Only provide a CT scan if the surgeon requested one based on their judgment of the X-rays. Model 2: CT scans for all displaced intra-articular DRF.
For choice of treatment, the NNS was lower for model 1 than for model 2 (2.6 vs. 4.3) and the NNH is higher for model 1 (3.1 vs. 1.3). For preoperative planning, the NNS (1.3 vs. 1.4) and NNH (3.7 vs. 3.4) were comparable for both models. Surgeons are able to predict the usefulness of an additional CT scan for intraarticular displaced DRF for OR indication. However, for pre-operative planning the usefulness of a CT scan is much harder to predict.