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Eur Radiol ; 26(3): 722-32, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26139315

RESUMO

OBJECTIVES: To evaluate the prevalence of injuries of the scapholunate and lunotriquetral interosseous ligaments (SLIL, LTIL) as well as the triangular fibrocartilage complex (TFCC) in intra-articular distal radius fractures (iaDRF). METHODS: Two hundred and thirty-three patients with acute iaDRF underwent MDCT arthrography. The SLIL and LTIL were described as normal, partially or completely ruptured. Major injuries of the SLIL were defined as completely ruptured dorsal segments, those of the LTIL as completely ruptured palmar segments. The TFCC was judged as normal or injured. Interobserver variability was calculated. Injury findings were correlated with the types of iaDRF (AO classification). RESULTS: In 159 patients (68.2 %), no SLIL injuries were seen. Minor SLIL injuries were detected in 54 patients (23.2%), major injuries in 20 patients (8.6%). No correlation was found between the presence of SLIL lesions and the types of iaDRF. Minor LTIL injuries were seen in 23 patients (9.9%), major injuries in only 5 patients (2.2%). The TFCC was altered in 141 patients (60.5%). Interobserver variability was high for MDCT arthrography in assessing SLIL and TFC lesions, and fair for LTIL lesions. CONCLUSION: In iaDRF, prevalence of major injuries of the most relevant SLIL is about 9% as evaluated with CT arthrography. KEY POINTS: The C-shaped SLIL is built of dorsal, middle and palmar segments. In iaDRF, major SLIL injuries are associated in 8.6% of the cases. In iaDRF, the SLIL remains intact in 68.3% of the cases. IaDRF and SLIL ruptures can comprehensively be depicted with MDCT arthrography. A three-compartment approach is recommended to assess intrinsic ligaments and the TFCC.


Assuntos
Ligamentos Articulares/diagnóstico por imagem , Ligamentos Articulares/lesões , Tomografia Computadorizada Multidetectores , Fraturas do Rádio/diagnóstico por imagem , Fibrocartilagem Triangular/diagnóstico por imagem , Fibrocartilagem Triangular/lesões , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Prevalência , Rádio (Anatomia)/diagnóstico por imagem , Rádio (Anatomia)/lesões , Traumatismos do Punho/diagnóstico por imagem , Articulação do Punho/diagnóstico por imagem , Adulto Jovem
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