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. 2015 Nov 16;47(1):27-30.
doi: 10.1016/S2255-4971(15)30342-6. eCollection 2012 Jan-Feb.

WHAT IS THE BEST RADIOGRAPHIC VIEW FOR "DIE PUNCH" DISTAL RADIUS FRACTURES? A CADAVER MODEL STUDY

Diego Figueira Falcochio  1 , Bruno Eiras Crepaldi  2 , Christiano Augusto Trindade  2 , Antonio Carlos da Costa  2 , Ivan Chakkour  3
Affiliations

WHAT IS THE BEST RADIOGRAPHIC VIEW FOR "DIE PUNCH" DISTAL RADIUS FRACTURES? A CADAVER MODEL STUDY

Diego Figueira Falcochio et al. Rev Bras Ortop. .

Abstract

Objective: the aim of this study is try to show the best view for distal radius fractures so called die-punch fractures.

Methods: There has been used a human cadaver radius bone from the Salvador Arena Tissue Bank. This bone was cleaned up after removing the soft tissues and osteotomies created displaced lunate fossa fractures of 0, 1, 2, 3 and 5 mm. We have fixed this fragment with adhesive tape. Then the joint deviation were significantly increased with step-offs of 1 mm. Radiographs were then taken into 5 different positions: postero-anterior view, lateral view, oblique views and tangencial view for each of the deviations. The resulting lunate fossa depression in each X-ray film was analyzed by the AutoCAD 2010® software.

Results: The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees. The pronated oblique view was the best to see the 2mm degrees and the oblique supinated view wasn't able to see the degrees between 1 and 2mm.

Conclusion: The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees.

Keywords: Cadaver; Radius Fractures/radiography; Radius Fractures/surgery.

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Figures

Figure 1
Figure 1
Tangential view with the forearm at 75° to the plane of the table, wrist at maximum flexion and ampulla perpendicular to the table.
Figure 2
Figure 2
Photograph of the dorsal face of the distal region of the radius, demonstrating the bone failure and the distal fragment that separated.
Figure 3
Figure 3
Joint step of 1 mm, measured using digital calipers, and bone fragment fixed with colorless adhesive tape.
Figure 4
Figure 4
Position of the radius during radiographs in the following views: (A) front; (B) lateral; (C); GBP; (D) OSS; and (E) tangential.
Figure 5
Figure 5
Deviation of 3 mm in tangential view, with respective measurements using the AutoCAD 2010® software.
Figure 6
Figure 6
Amount of the joint step on the x-axis and its radiographic representation, according to view, on the y-axis. Dentro da figura: AP, Lateral, OSP, OSS, Tangential.
Figure 7
Figure 7
Radiographs with joint steps of 1, 2, 3 and 5 mm in the front, lateral, OSP, OSS and tangential views.
See this image and copyright information in PMC

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