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Distal Radial Frx: Radial Length


- Distal Radial Length:
    - shortening results from extensive comminution and impaction of frx fragments into the metaphysis;
    - shortening of radius is more disabling than an angulatory deformity of the distal radius (ie, dorsal tilt or loss or radial inclination);
    - radial shortening following distal radial frx may lead to acquired positive ulnar variance, ulnar impaction syndrome, and  instability;
           - patients will often have significant loss of pronation and suprination;
           - some authors, in fact, note that radial shortening is only important in so much that it reflects a change in ulnar variance;
                  - usually a change of more than 3 mm of ulnar variance will lead to symptoms;
    - radiographic measurement:
           - for precise measurement, a true lateral radiograph of both wrists should be obtained in order to compare the radial lengths of the injured and the non injured wrists;
           - mark two lines perpendicular to long axis of the radius;
           - first line intersects tip of radial styloid;
           - second line intersects distal articular surface of ulnar head;
           - distance between two lines, is called radial length should be 11 to 12 mm;
    - acceptable reduction:
           - normal length of radius averages 9-12 mm;
           - shortening of upto 3-5 mm can be associated w/ a satisfactory result, as long as there is an accurate articular restoration, however, the surgeon should strive to achieve less than 2 mm of shortening;
           - greater than 10 mm of shortening is often associated w/ symptoms, including involvement of distal RU joint
    - management:
           - when radial shortening is due to comminution, then external fixation is the most reliable method of restoring length

Correction of Post-Traumatic Wrist Deformity in Adults by Osteotomy, Bone Grafting, and Internal Fixation.

Classification of distal radius fractures.

Fractures of the distal end of the radius in young adults: a 30-year follow-up.

Minor axial shortening of the radius affects outcome of Colles' fracture treatment.

Intrafocal (Kapandji) pinning of distal radius fractures with and without external fixation.

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