Distal Radius Volar Shear Fractures: A Computed Tomography Characterization and Analysis

Area of Science:

• Orthopedic Surgery
• Radiology
• Trauma Surgery

Background:

• Volar shear fractures of the distal radius present diagnostic challenges.
• Radiographic evaluation may underestimate fracture complexity, particularly dorsal involvement.

Purpose of the Study:

• To characterize volar shear fractures using computed tomography (CT).
• To evaluate dorsal cortical involvement, articular complexity, and morphologic features for operative planning.

Main Methods:

• Retrospective review of 110 CT-confirmed volar shear distal radius fractures.
• Classification using the AO/OTA system and CT-based morphologic characterization.
• Comparison of demographic and fracture characteristics across fracture types.

Main Results:

• Dorsal cortical fractures present in 70% of volar shear fractures.
• CT led to reclassification in 44% of B3 and 28% of transitional-B3 fractures.
• Type C fractures showed increased fragmentation, longitudinal splits, and articular depression.

Conclusions:

• Dorsal cortical extensions are common in volar shear fractures and may indicate articular complexity not seen on radiographs.
• CT imaging offers crucial details for accurate diagnosis and guides comprehensive fixation strategies.