The evaluation of a new digital semi-automated system for the radiological assessment of distal radial fractures

Objective: To compare intra- and inter-observer variation for measurements of wrist deformity using a manual method of measurement and a semi-automated digital system developed in our department. Design: Four observers measured radial angle, radial shift, radial length, palmar tilt, and dorsal shift on ten wrist-fracture films using a standardised protocol. Each observer made measurements directly from the radiograph on three occasions, and on a further three occasions digitised images were viewed and measurements made with semi-automated on-screen measurement tools. Results: Manual measurements took 12 min per case compared with 3 min for the digital system. The digital system resulted in improved intra-observer variation for all measurements and an improvement in inter-observer variation for all measurements except posterior tilt. Conclusion: The new system allows greater precision in assessing fracture reduction and follow-up. Its principal application is in studies that utilise the wrist as a model for fracture healing.