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Systematic evaluation of concomitant extensor tendon sheath injury in patients with distal intra-articular radial fractures in MDCT using the floating fat sign

  • Musculoskeletal
  • Published:
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Abstract

Objectives

We aimed to evaluate the involvement of extensor tendon sheaths in a large MDCT study group of patients with distal intra-articular radial fractures using the floating fat sign.

Methods

603 MDCT scans of patients with acute intra-articular distal radial fractures (Frykman III-VIII) acquired between January 2005 and October 2011 were analysed in consensus by two radiologists. The extensor tendon sheath involvement was assessed for each extensor tendon compartment and visually graded from 0 to 2 based on the amount of fat-fluid levels.

Results

Extensor tendon sheath involvement with fat-fluid levels was observed in 71.0% of the distal radial fractures, mainly in the second or third compartment. The frequency and degree of tendon sheath involvement was not related to the fracture severity. There was no statistically significant difference in the frequency of tendon effusion between the CT scans acquired before or after closed reduction.

Conclusion

Traumatic rupture of the extensor tendon sheaths with concomitant fatty effusion is a common finding in patients with distal intra-articular radial fractures.

Key points

• Fat effusions in tendon sheaths are frequent in distal intra-articular radial fractures.

• Fat effusions in tendon sheaths are caused by traumatic bone marrow spilling.

• Effusions typically involve the second and third compartment simultaneously.

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Abbreviations

APL:

Abductor pollicis longus

EPB:

Extensor pollicis brevis

ECRB:

Extensor carpi radialis brevis

ECRL:

Extensor carpi radialis longus

EPL:

Extensor pollicis longus

EIP:

Extensor indicis proprius

EDC:

Extensor digitorum longus

EDQ:

Extensor digiti quinti proprius

ECU:

Extensor carpi ulnaris

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Acknowledgements

The scientific guarantor of this publication is Christian von Falck. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: Retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Hanover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany

    Amelie von Schneider-Egestorf, Bernhard Meyer, Frank Wacker & Christian von Falck

  2. Department of Diagnostic and Interventional Radiology, KRH Klinikum Siloah-Oststadt-Heidehaus, Stadionbrücke 4, 30459, Hannover, Germany

    Herbert Rosenthal

Authors
  1. Amelie von Schneider-Egestorf
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  2. Bernhard Meyer
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  3. Frank Wacker
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  4. Herbert Rosenthal
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  5. Christian von Falck
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Correspondence to Christian von Falck.

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von Schneider-Egestorf, A., Meyer, B., Wacker, F. et al. Systematic evaluation of concomitant extensor tendon sheath injury in patients with distal intra-articular radial fractures in MDCT using the floating fat sign. Eur Radiol 27, 4345–4350 (2017). https://doi.org/10.1007/s00330-017-4787-y

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  • DOI: https://doi.org/10.1007/s00330-017-4787-y

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