X-ray of distal radius fractures

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File:Collesfracture.jpg
Distal radius fracture

Author: Mikael Häggström [notes 1]

In projectional radiography ("X-ray") of a distal radius fracture, the most important findings are displacement and whether there is intra-articular involvement.

Quality checking

The radius should form the contour dorsally in order to better detect even undisplaced fractures.

Displacement

Dorsal or volar tilt

File:Dorsal tilt of distal radius fracture.jpg
Fracture with a dorsal tilt: Dorsal is left, and volar is right in the image.

The dorsal or volar tilt can be described by an angle from the axial plane of the radius, shown in red in the image at right, and goes between:[1]

  • A line drawn between the distal ends of the articular surface of the radius.
  • The axial plane of radius: Represented by a line that is perpendicular to the diaphysis of the radius.

Sometimes, the diaphysis of the radius is hard to distinguish from the ulna, and a line between them (turquoise line) may be used instead.[2]

Although this is the standard definition of dorsal or volar tilt, the parameter can be interpreted by clinicians as being in relation to the normal anatomical position of the articular surface of radius (which normally has a volar tilt of 11° to 12°), and should therefore be specified as shown in report.

Other important features

Check if present or absent:

  • Displacemen in other directions
  • Comminuted fracture, particularly if it has intra-articular involvement
  • Other skeletal fractures, commonly a loose ulnar styloid process.

Report

  • If volar or dorsal tilt:
  • The degree thereof
  • That is it in comparison to the axial plane of radius (to avoid mixup with being in relation to the normal anatomical position)
  • Other important features, if present

See also: General notes on reporting

See also

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Piva Neto, Antonio; Lhamby, Fabio Colla (2011). "Fixação das fraturas da extremidade distal do rádio pela técnica de kapandji modificada: avaliação dos resultados radiológicos ". Revista Brasileira de Ortopedia 46 (4): 368–373. doi:10.1590/S0102-36162011000400004. ISSN 0102-3616. 
  2. Dr Paresh K Desai. Colles fracture. Radiopedia. Retrieved on 2016-12-18.