Schmehl, Lucas
[Verfasser:in]
;
Mutze, Sven
[Akademische:r Betreuer:in];
Wacker, Frank
[Akademische:r Betreuer:in]Universität Greifswald
Inzidenz und Dunkelziffer von knöchernen Handgelenks- und Handverletzungen auf Ganzkörper-Computertomographien in einem Traumazentrum der Maximalversorgung
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Titel:
Inzidenz und Dunkelziffer von knöchernen Handgelenks- und Handverletzungen auf Ganzkörper-Computertomographien in einem Traumazentrum der Maximalversorgung
Background: To investigate the incidence of osseous wrist and hand injuries on whole-body computed tomographies (WBCT) at an urban maximum-care trauma center, to report the number of missed cases in primary radiology reports, and to develop an algorithm for improved detection of these injuries. Methods: Retrospective analysis reviewing all WBCT for a period of 8 months for osseous wrist and hand injuries. (1) Reconstruction of hands/wrists in three planes (thickness 1–2 mm) and analysis by a blinded musculoskeletal radiologist. (2) Scanning of primary radiology reports and comparison to the re-evaluation.(3) Calculation of the diagnostic accuracy of WBCT during primary reporting.(4) Search for factors potentially influencing the incidence (trauma mechanism, associated injuries, Glasgow Coma Scale, artifacts). (5) Development of an algorithm to improve the detection rate. Results: Five hundred six WBCT were included between 01/2020 and 08/2020. 59 (11.7%) WBCT showed 92 osseous wrist or hand injuries. Distal intra-articular radius fractures occurred most frequently (n = 24, 26.1%); 22 patients (37.3%) showed multiple injuries. The sensitivity of WBCT in the detection of wrist and hand fractures during primary evaluation was low with 4 positive cases identified correctly (6.8%; 95% CI 1.9 to 16.5), while the specificity was 100% (95% CI 99.2 to 100.0). Forty-three cases (72.9%) were detected on additional imaging after clinical reassessment. Twelve injuries remained undetected ...