Use of Standard and Anatomic-Tilt Lateral X-rays to Determine Distal Radius Volar Angulation

Standardised post-operative radiographs for volar radial plate fixation: the '22/11 X-ray'

“…12 Yi et al studied the use of anatomically tilted lateral radiographs on the determination of the restoration of normal volar tilt, finding moderate to excellent reliability but no statistically significant differences compared with standard lateral radiographs. 13 It should be emphasised that this study did not attempt in any way to determine the diagnostic usefulness of tilted radiographs for joint penetration and thus no 'gold-standard' was applied for comparison. It was assumed that most, if not all, implants had been checked at multiple angles by the operating surgeon intraoperatively and were known to be extra-articular.…”

“…13 They used a 23° tilted lateral radiograph of the wrist, and measured intra-and inter-observer variability in the measurement of volar angulation between a specialist orthopaedic hand surgeon, a specialist hand fellow, and a senior orthopaedic registrar. Intra-observer reliability was excellent for the tilted lateral radiographs compared to the standard films for both patients and controls, especially for the more senior observers.…”

Natural history and factors associated with ulnar-sided wrist pain in distal radial fractures treated by plate fixation

“…Radiographic parameters for reduction were radial inclination, anterior angulation and ulnar variance; these were assessed at 3 months post-operatively using plain postero–anterior and anatomical 23° tilted lateral wrist radiographs. The radial inclination and ulnar variance were measured using the method described by Medoff (2005) and anterior angulation using the method of Yi et al (2012). The presence of a USF was determined by immediate post-operative postero–anterior radiographs.…”

Intra-articular comminution worsens outcomes of distal radial fractures treated by open reduction and palmar locking plate fixation

“…Plain posteroanterior and 23° anatomical tilt lateral wrist radiographs (Yi et al 2012) were obtained at the 2-year follow-up visits. Radiographic reduction was assessed by measuring radial inclination, anterior angulation and ulnar variance; radial inclination and ulnar variance were measured as described by Medoff (2005) and palmar angulation was measured as described by Yi et al (2012). Post-traumatic arthritis was scored by the Knirt and Jupiter (1986) grading system (0, none; 1, slight joint space narrowing; 2, marked joint space narrowing; 3, bone-on-bone, osteophyte/cyst formation).…”