Scaphoid alignment in dorsally displaced distal radial fracture: a radiographic study

We aimed to establish if fracture reduction will correct scapholunate angle in dorsally displaced distal radial fractures and to identify the relationship with other measures of distal radial position and carpal alignment. Radiographs of 131 patients with a distal radial fracture and of 50 patients with normal radiographs were reviewed. We measured the scapholunate, radiolunate, capitolunate and metacarporadial angles on the lateral views. Linear regression modelling showed that all parameters measured were significantly associated with scapholunate angle on the first radiograph following injury. Scapholunate angle increased following distal radial fracture. Reduction of the fracture improved scapholunate angle, and this was most strongly related to change in dorsal tilt. We conclude that scaphoid flexion is likely to compensate for the dorsal tilt of the lunate as an attempt to counter its dorsal tilt, and to stabilize the wrist to maintain hand function.Level of evidence: IV.