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Dorsal Tilt of the Distal Radius Fracture Changes With Forearm Rotation When Measured on Radiographs
Janni Jensen1,2,3, Hans B Tromborg4,5, Benjamin S B Rasmussen1,2,3
1Department of Radiology, Odense University Hospital, Odense, Denmark.
Journal of Hand Surgery Global Online
|April 13, 2022
Summary
Forearm rotation during X-rays significantly affects distal radius fracture tilt measurements. Pronation increases apparent dorsal tilt, while supination decreases it, impacting clinical decisions.
Area of Science:
- Orthopedic surgery
- Radiology
- Biomechanics
Background:
- Distal radius fractures are common injuries.
- Accurate radiographic assessment is crucial for treatment planning.
- Forearm rotation can potentially influence radiographic measurements.
Purpose of the Study:
- To investigate the impact of pronation and supination on radiographic measurements of dorsal tilt, radial inclination (RI), and ulnar variance (UV).
- To assess the reliability of these measurements in cadaveric distal radius fractures.
Main Methods:
- 21 cadaveric forearms with created distal radius fractures were used.
- Radiostereometric analysis (RSA) markers were inserted for precise rotation tracking.
- Radiographs were taken at varying degrees of pronation and supination.
- Two blinded observers measured tilt, RI, and UV.
- Univariate linear regression analyzed the relationship between rotation and measurements.
Main Results:
- Forearm rotation significantly affected dorsal tilt measurements.
- A 10° change in rotation altered dorsal tilt by approximately 3°.
- Radial inclination (RI) and ulnar variance (UV) measurements were not significantly impacted by rotation.
Conclusions:
- Forearm positioning during radiography is critical for accurate dorsal tilt assessment in distal radius fractures.
- Pronation increases apparent dorsal tilt, while supination decreases it.
- Measurements of RI and UV remain reliable regardless of forearm rotation.
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