Radiographic Measurements on the Radio-Carpal Joint in Distal Radial Fractures

Abstract

Radiography of 40 wrists with fractures in the distal part of radius was performed. In the lateral view the inclination of the radial joint surface was analysed in different degrees of pronation and supination. The central ray was directed 15 degrees proximally and the results were compared with those obtained with a perpendicular central ray. In the perpendicular projections even moderate differences in pronation or supination between two examinations could seriously alter the measured inclination of the joint surface of the radius. The projection with the central ray directed 15 degrees proximally highly significantly decreased the errors between the measurements when compared to the perpendicular projection. The joint surface was depicted more dorsally inclined than in the perpendicular projection.

Angle measurements of the distal radius: a cadaver study

“…Observer variability in measurement of distal radius angles has been addressed in two previous studies [1,2]. Friberg and Lundstrom [2] measured radial angle and palmar tilt on 60 normal radiographs.…”

“…A lateral radiograph with the X-ray beam directed 15 ~ cephalad was also made (Fig. 1) [2,3]. Radiographs were randomly labeled so observers could not tell which, if any, were related.…”

“…Lateral radiographs were taken at 5 ~ rotational increments from 20 ~ pronation to 20 ~ supination. Lateral views with the X-ray beam directed 15 ~ cephalad were also taken in each position [2,3]. Palmar tilt was measured on all radiographs and plotted as a function of forearm rotation.…”

“…We measured overlap of the distal ulna on the radius to assess "acceptability" of the latcral views. An "acceptable" lateral radiograph is generally regarded as one in which the head of the ulna is completely superimposed on the distal radius [2].Acceptability of fracture reduction of distal radius fractures is based in part on radial angle in the coronal plane (anteroposterior radiograph) and palmar tilt in the sagittal plane (lateral radiograph) [4]. Reliable measurements are needed to make sound therapeutic decisions and assess results of treatment.…”

Radiologic Assessment of Angular Wrist Parameters of Asymptomatic Nigerians

“…[1,2] However, the morphometric interpretation of the wrist bone anatomy is dependent on the quality of the appearance and location of the bony landmarks which is significantly influenced by the positioning of the arm, forearm and wrist in relation to the x-ray beam. [3][4][5][6] The significant morphological variations observed at the wrist joint are certainly factors that could result in wrist abnormalities. [4,5] Gilula and Chesaru measured the scapholunate angle and reported that 30-60° was normal, [7] while 60-80° was questionably abnormal, and >80° out-rightly abnormal and the capitolunate angle of <30° was normal.…”