Volume CT of the Wrist and Carpus After Trauma

Study Overview
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Brief Summary
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The purpose of this study is to evaluate whether standard volume computed tomography (CT) has impact on treatment in patients with suspicion of fractures of the wrist and carpus.

Official Title
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Volume CT of the Wrist and Carpus After Trauma: A Pilot Study

Conditions
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Wounds and Injuries, Wrist Injuries

Intervention / Treatment
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* Radiation: Volume Computed Tomography of the wrist and carpus


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients (18 years and older) who are referred to our hospital for conventional radiography of the wrist and carpus Recent trauma mechanism (within 3 days before presentation) Clinical suspicion of fractures of the wrist and carpus. The carpus includes all carpal bones, but does not include the metacarpal bones. Exclusion Criteria: Patients who were not evaluated by a clinician before imaging was performed. Open fractures No informed consent or no prospective data collection could be obtained. Informed consent cannot be obtained in case patients do not speak or understand Dutch. Patients who cannot be positioned in upright position, immobilized on a spine board or transferred to the intensive care unit and cannot undergo upright CT

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Adult, clinical suspicion fractures wrist or carpus<br>- Patients (18 years and older) who are referred to our hospital for conventional radiography of the wrist and carpus | Radiation: Volume Computed Tomography of the wrist and carpus<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients with prospectively documented treatment changes after CT | This endpoint is defined as presence of difference in predefined treatment regimens before and after CT. These regimens include: -Conservative treatment on the emergency ward (functional, immobilization with bandage, cast, or closed reduction and cast), closed operative treatment (reduction and cast on operation room, percutaneous pinning, or external fixation), open surgical treatment (dorsal, radial, or palmar exposure with reduction and internal fixation). Additional regimens include: Second opinion from a colleague or consulting a different specialism. | within same visit (i.e. in one day) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnostic performance of CT and conventional radiography (CR) for fracture pattern | Fracture patterns are classified according to presence and type of fractured bones, presence of intra-articular components of distal radius fractures (including sigmoid notch involvement), presence of (fracture) dislocation or avulsion fractures of carpal bones. Standard of reference is presence of injuries at imaging, at surgery, and disability complains at 1-year follow up. In case of discrepancy, consensus will be reached at the end of the study by a panel of trauma surgeons and radiologists. | within the same visit (one day) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Radius fracture, Scaphoid fracture, Tomography, x-ray computed