In Reply

In our study we did not investigate the need for preoperative or postoperative computed tomography (CT) investigations in intra-articular fractures but the evidence of postoperative routine control using standard x-rays in distal radius and ankle joint fractures of any kind.

Patients in whom after osteosynthesis the surgeon indicated the need for postoperative CT scanning were excluded from our study, as described in the article (1).

Regarding item 1: We support this comment, but it was not the subject of our study.

Regarding items 2 and 3: Is there evidence to support this comment, or a guideline?

Regarding item 3: The reconstruction of the articular surface under direct visualization is a principle that in a selected group of distal intra-articular fractures (stabilized dorsally or controlled by arthroscopy) is certainly valid. But as far as we are aware neither the literature stipulates a general requirement for this to be applied to all intra-articular radius fractures, nor has it become established in routine clinical practice. It is not the rule either in ankle fractures, even though the joint may be involved (for example, Volkmann fractures).

Regarding item 5: When and if a control CT scan is indicated we agree with the comments.

Regarding items 6–8: CT obviously provides more detailed information than an x-ray, but in our clinical experience, most of the clinically necessary information can be exposed by means of standardized x-ray images. Future studies will have to address the clinical relevance of routine postoperative CT scans and the number and frequency of radiological follow-up investigations.