Review distal radius fracture X-ray signs, Colles, Smith, Barton, intra-articular extension, dorsal tilt, radial height, ulnar variance, DRUJ alignment, and associated TFCC or scapholunate injury clues.
Distal radius fractures are the most common fractures in the upper extremity, typically resulting from a fall on an outstretched hand. They are classified by fracture pattern (Colles, Smith, Barton, chauffeur), articular involvement, and displacement. Radiographic measurements including radial height, radial inclination, and volar tilt guide treatment decisions. MRI can identify associated soft tissue injuries including TFCC tears and scapholunate ligament injuries. Our AI consortium evaluates fracture pattern, measures alignment parameters, and identifies associated injuries.
Wrist X-ray is the first-line imaging test for most suspected distal radius fractures. Open PA, lateral, and oblique views in the free wrist X-ray viewer for private browser-based viewing, then compare associated ulnar-sided pain with TFCC tear or carpal widening with scapholunate injury.
Accepted alignment thresholds include radial height of at least 10 mm (normal 11-12 mm), radial inclination of at least 15 degrees (normal 22-23 degrees), and volar tilt between negative 10 and positive 20 degrees (normal positive 11-12 degrees). Articular step-off or gap exceeding 2 mm at the radiocarpal or distal radioulnar joint is a strong indication for fixation. Radial shortening beyond 5 mm compared to the contralateral side predicts DRUJ instability and ulnar-sided symptoms. Our AI measures all of these parameters on standard PA and lateral radiographs and flags values outside acceptable range.
Concurrent soft tissue injuries occur in 50-70% of distal radius fractures detected arthroscopically. The most common are TFCC tears (Palmer 1D radial-sided tears from the sigmoid notch), scapholunate ligament tears, and lunotriquetral ligament injuries. Acute carpal tunnel syndrome from hematoma compressing the median nerve requires urgent decompression. MRI characterizes these associated injuries when post-reduction symptoms persist or before surgical planning. Our AI evaluates the TFCC, intrinsic carpal ligaments, and median nerve on wrist MRI obtained after fracture stabilization.
The ulnar styloid is the attachment point for the foveal component of the TFCC and the ulnocarpal ligaments. Base-of-styloid fractures that displace the foveal insertion destabilize the DRUJ and increase the risk of chronic DRUJ instability and ulnar-sided pain. Tip fractures rarely affect DRUJ stability. Our AI identifies ulnar styloid fracture level and displacement, which helps determine whether the DRUJ requires stabilization in addition to distal radius fixation and whether TFCC repair is indicated.
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