Marquez FK, Garzón ADA, Vergara AE

Language: Spanish
References: 13
Page: 332-351
PDF size: 1420.88 Kb.

ABSTRACT

A distal radial fracture may occur as a result of axial compression of the wrist. The most common treatments include the conservative approach (plaster cast immobilization) and surgery. In the latter procedure, plates and screws are used to fix the fracture after reduction. However, it may be difficult to determine the relative position of the screws with respect to the articular surface, due to the complex anatomy of this structure. To solve this problem, standard radiological imaging has been used to determine the palmar and radial tilt of the articular surface. Based on the angles obtained, the forearm is tilted in such a way that when the radiograph is taken the articular surface labia overlap. However, this method is not very effective to determine tilt, since the biplane and biconcave anatomy of the articular zone are not considered simultaneously. A methodology is proposed to find the angles determining articular surface orientation by means of three-dimensional reconstruction based on axial tomography imaging. Such tilt measurements will make it possible to obtain a tangential view of the distal radial articular surface and determine the relative position of fixation screws with respect to it. In a case study it was found that total radial tilt of the articular surface was 13° and palmar tilt was 6° with respect to a line perpendicular to the central axis of the radius. This outcome differs from findings by other authors, who propose a radial angle of 22° to 24° and a palmar angle of 9° to 12°. Additionally, for the surface articulating with the semilunar bone, radial tilt was found to be 7° and palmar tilt 10°, whereas in the fossa which is in contact with the scaphoid bone, radial tilt is 21° and palmar tilt 8° in the case analyzed.

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