Radial Fractures

Question 1

What are the acceptable paramaters for distal radius fractures?

Answer 1

Radial Height
Normal = 11mm​
Acceptable = <5mm shortening

Radial Inclination
Normal = 22 Degrees​
Acceptable = <5 degree change

Articular Step Off
Normal = Congruous​
Acceptable = <2mm step

Question 2

What are unacceptable features of distal radial fracturs

Answer 2

> 10 degrees of dorsal tilt
Loss of radiocarpal alignemnt
5mm positive ulnar variance
2 mm articular step

Question 3

What classification system do you know for distal radial fractures?

Answer 3

Frykman classification:
Type I – Transverse Metaphyseal fracture
Type II – Transverse Metaphyseal fracture + ulna styloid #
Type III – Radiocarpal joint involvement
Type IV – Radiocarpal joint involvement + ulna styloid #
Type V – Radioulnar joint involvement
Type VI – Radioulnar joint involvement + ulna styloid #
Type VII – Involvement of both radiocarpal + radioulnar joints (comminuted fracture)
Type VIII – Radiocarpal + radioulnar + ulna styloid #

Question 4

What are approches to fixing distal radial fractures?

Answer 4

FCR - Plane of FCR and FPL
Modified henrys - Plane between flexor carpi radialis tendon and the radial artery.

Question 5

What are methods of fixing distal radial fractures?

Answer 5

Volar Locking Plat
K Wire fixation

Question 6

Describe LaFotaines Criteria

Answer 6

Predictors of fracture instability

1) Initial dorsal fracture angulation > 20 degrees,
2) dorsal comminution
3) Radiocarpal joint extension
4) associated ulnar fracture
5) age > 60 years.