الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Wrist is a complex joint both anatomically and physiologically. It is one of the joints that get injured commonly and can have significant functional impact on day-today activities. Therefore, it is important to manage injuries and pathologies of the hand and wrist.
Imaging plays an important role in guiding the management. Different modalities are used to image the wrist joint. Plain radiographs are routinely performed for acute and chronic wrist injuries. These are very useful in bone trauma.
Wrist fractures and dislocations may be overlooked on conventional radiographs. CT with multiplanar and volumetric reformation can be a useful technique to demonstrate occult carpal bone fractures. Also, it can illustrate the complexity and extent of fractures as well as joint dislocations.
This study aimed to evaluate the role of MDCT and MPR in assessment of fracture patterns around the wrist as when we tell the orthopedic surgeons about type and extensions of the fractures as well as associated injuries we put them at the beginning of the right way of management of those patients who come with acute wrist trauma.
Our study included forty patients with wrist trauma who had wrist radiographs in ER and referred from the orthopedic department for CT evaluation using 16 slice MDCT machine (GE Bright Speed, GE healthcare, Waukesha, WI and Toshiba Aquilion S16 CFX).
The study was conducted in the Radiology department at Minia University Hospital during the period from May to December 2018. Their ages ranged from 19 to 65 year with mean age of 37 year. wrist fractures in our study were significantly more common in males than females, 27 cases (67.5%) were males. left side was affected more than right side. Fall on out stretched hand was the most common cause of fractures.
When we use AO classification our results as follow 2 cases of type 23A2, 15 cases of type 23B, 21 cases of type 23C. This classification system is comprehensive; it can serve as a basic data for management.
from this study we conclude that: Conventional radiography is the initial modality available for wrist joint fractures but failed to detect occult fractures around the wrist joint which identified at MDCT, that suggest the importance of cross sectional imaging for fracture detection.
MDCT of the wrist is a widely available and easily performable test with minute contraindications.
MDCT imaging should be performed in patients with clinically suspected carpal injury even if the plain radiographs do not show any fracture.
MDCT is accurate in detection of carpal bone injuries and internal derangements of the wrist joint.
It is also useful in preoperative planning and postoperative follow-up of wrist injuries.
MDCT has revolutionized our understanding and characterization of these fractures and their management.
Fracture characterization is essential to guide the management of these injuries. The use of MDCT with MPR and 3D reformatted images allow better visualization of fracture lines, dislocation and comminuted fractures and optimal evaluation of the injury.
Distal radius fractures have many classifications more than 10 classification systems have been proposed. However, all classification systems have shown interobserver and intra-observer unreliability. Classification systems in their most useful form can be tools for successful, rapid communication in clinical contexts between healthcare professionals.