Accuracy and Reliability of Radiographic Estimation of Volar LipFragment Size in PIP Dorsal Fracture-Dislocations

摘要

Background: A cadaveric study was performed to evaluate the accuracyand reliability of radiographic estimation of the volar lip fragment size inproximal interphalangeal joint fracture-dislocations. Methods:Middle phalangeal base volar lip fractures of varying size and morphology weresimulated in 18 digits. Radiographs and digital photographs of the middlephalangeal joint surface were obtained pre- and postinjury. Ten orthopedicsurgeons of varying levels of training estimated the fracture size based onradiographs. The estimated joint involvement on radiograph was compared with thedigitally measured joint involvement. Results: Radiographicestimation underestimated the volar lip fragment size by 9.02%. Estimationspossessed high intraobserver (0.76-0.98) and interobserver (0.88-0.97)reliabilities. No differences were detected between levels of surgeon training.Conclusions: The significant underestimation of the volar lipfragment size demonstrates the lack of radiographic estimation accuracy andsuggests that surgeons should be mindful of these results when making treatmentplans.