Evidence map›Paper›PMID 41876938›Full record

ArticleEmergency radiology2026

Imaging the joint above and below: investigating the need for "completion imaging" in geriatric fragility distal radius fractures.

Michael G Flood, Joseph O Werenski, Patrick Curtin, Samuel Rice, Antonio Lobao, Max Vaickus, Madison Jones, Matthew W DeFazio, Marci D Jones

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Article in Emergency radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Michael G FloodDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA. mike.flood97@gmail.com.ORCID http://orcid.org/0009-0002-2515-7285
Joseph O WerenskiDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Patrick CurtinDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Samuel RiceDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Antonio LobaoDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Max VaickusDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Madison JonesDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Matthew W DeFazioDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Marci D JonesDepartment of Orthopaedics and Physical Rehabilitation, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDistal radius fragility fractures (DRFFs) are common injuries in older adults following low-energy falls. While wrist radiographs are standard, additional “completion imaging” of the ipsilateral hand, forearm, and elbow is frequently obtained, though its diagnostic yield and clinical utility are poorly defined. This study aimed to evaluate the yield of completion imaging in DRFFs and identify risk factors for concomitant injuries outside the wrist.

methodsA retrospective cohort study was conducted at a tertiary academic center from 2017-2024. Patients aged ≥50 years with radiographically confirmed DRFFs sustained from low-energy mechanisms were included. Demographic, clinical, fracture, and imaging data were abstracted. Completion imaging yield was defined as the proportion of patients with additional injuries detected, with 95% confidence intervals (CIs) calculated using Wilson’s method. Univariable analyses were performed to assess associations between patient factors and concomitant injuries, with statistical significance defined as p<0.05.

resultsA total of 188 patients met inclusion criteria. The median age was 77 years (interquartile range [IQR]: 71-86), and 90% were female. Most fractures were AO Foundation/Orthopaedic Trauma Association (AO/OTA) type 23A (47%) or 23C (30%). Concomitant injuries outside the wrist and forearm occurred in 51 patients (27%), most commonly hip or pelvic ring fractures (6%), followed by shoulder/clavicle (4%) and intracranial injuries (4%). Completion imaging was obtained in 179 patients (95%), with a low diagnostic yield of 3.8% for hand radiographs, 3.9% for elbow radiographs, and 0% for forearm radiographs. All additional injuries were clinically suspected. AO/OTA fracture pattern was significantly associated with concomitant injuries (p=0.04), whereas age, sex, mechanism, and ambulatory status were not (all p>0.05).

conclusionsCompletion imaging in older adults with low-energy DRFFs demonstrated low diagnostic yield, with additional injuries identified only when clinically suspected. Forearm radiographs may offer limited value, while hand and elbow imaging should be targeted to patients with focal tenderness or communication barriers. Given that over one-quarter of patients had concomitant injuries, clinicians should remain vigilant beyond the wrist, and prospective studies with safety evaluation are needed to define optimal imaging strategies. LEVEL OF EVIDENCE: III, retrospective cohort study

Indexed as

Radius FracturesWrist FracturesAccidental FallsAgedAged, 80 and overFemaleHumansMaleRadiographyRetrospective StudiesRisk FactorsCompletion imagingConcomitant injuryDistal radius fragility fracturesOsteoporotic fractureRadiographic yield

Identifiers

PMID41876938

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.