Distal radius fracture x ray

Distal radius fracture Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

X Ray

• Radiographic imaging is important in diagnosis, classification, treatment and follow-up assessment of distal radius fractures.
• The routine minimal evaluation for distal radius fractures must include two views-a postero-anterior (PA) view and lateral view.
• Positioning for the x-rays:
  • The posteroanterior view should be acquired with the patient’s elbow and shoulder at 90° and the forearm in neutral rotation.
  • When the lateral view is acquired correctly, i.e., in the absence of relative pronation or supination, the pisiform bone should be superimposed on the distal pole of the scaphoid.

Radial Length

• It is used when assessing shortening of the radius after fracture, can be obtained using the posteroanterior view.
• Method:
  • Two lines are drawn perpendicular to the long axis of the radius, one at the tip of the radial styloid and the second at the ulnar border of the distal radial articular surface.
• Normally, this length is about 12 mm.
• Excessive radial shortening after fracture of the distal radius may be associated with tears of the triangular fibrocartilage complex (TFCC).

Radial Inclination

• Method:
  • Radial inclination is the angle between a line perpendicular to the central axis of the radius and a line connecting the radial and ulnar limits of the articular surface of the distal radius.
• The articular surface of the distal radius exhibits approximately 23° (range:13–30°) of normal radial inclination.

Ulnar Variance

• Ulnar variance, defined as neutral, positive, or negative, is evaluated on the frontal view.
• Method:
  • Ulnar variance, according to the method of perpendiculars, is the vertical distance between two tangential lines both perpendicular to the long axis of the radius.
  • One line is drawn at the level of the radial sigmoid notch and the second at the level of the lateral cortical margin of the distal ulna.
• With excessive radial shortening, ulnar positive variance will be present.