Use of Articular Wrist Views to Assess Intra-Articular Screw Penetration in Surgical Fixation of Distal Radius Fractures

The use of volar locking plates for fixation of distal radius fractures is increasing in modern orthopedic practice. They have the advantage of limited dissection, early mobilization, and improved function over previous fixation devices. Standard anteroposterior and lateral radiographs would normally be requested by the orthopedic team, but these may not give an accurate representation of the articular anatomy of the fracture fixation. This study evaluated the effectiveness of a series of radiographs, the articular wrist series, which accurately represent the wrist joint and clarify doubt regarding screw placement or articular congruity. With this method, 2 additional radiographs are taken and are oriented in such a manner as to produce an image parallel to the radiocarpal joint on both anteroposterior (11° elevation) and lateral (23° elevation) projections. Since the introduction of such a system, we have been able to interpret radiographs in this setting much more easily.