The Hip: Preservation, Replacement and Revision

Distal Radial Frx: Radial Length       

- Distal Radial Length:
    - shortening results from extensive comminution and impaction of frx fragments into the metaphysis;
    - shortening of radius is more disabling than an angulatory deformity of the distal radius (ie, dorsal tilt or loss or radial inclination);
    - radial shortening following distal radial frx may lead to acquired positive ulnar variance, ulnar impaction syndrome, and  instability;
           - patients will often have significant loss of pronation and suprination;
           - some authors, in fact, note that radial shortening is only important in so much that it reflects a change in ulnar variance;
                  - usually a change of more than 3 mm of ulnar variance will lead to symptoms;
    - radiographic measurement:
           - for precise measurement, a true lateral radiograph of both wrists should be obtained in order to compare the radial lengths of the injured and the non injured wrists;
           - mark two lines perpendicular to long axis of the radius;
           - first line intersects tip of radial styloid;
           - second line intersects distal articular surface of ulnar head;
           - distance between two lines, is called radial length should be 11 to 12 mm;
    - acceptable reduction:
           - normal length of radius averages 9-12 mm;
           - shortening of upto 3-5 mm can be associated w/ a satisfactory result, as long as there is an accurate articular restoration, however, the surgeon should strive to achieve less than 2 mm of shortening;
           - greater than 10 mm of shortening is often associated w/ symptoms, including involvement of distal RU joint
    - management:
           - when radial shortening is due to comminution, then external fixation is the most reliable method of restoring length

Correction of Post-Traumatic Wrist Deformity in Adults by Osteotomy, Bone Grafting, and Internal Fixation.

Classification of distal radius fractures.

Fractures of the distal end of the radius in young adults: a 30-year follow-up.

Minor axial shortening of the radius affects outcome of Colles' fracture treatment.

Intrafocal (Kapandji) pinning of distal radius fractures with and without external fixation.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, August 13, 2012 4:50 pm