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Distal radial fracture (Colles fracture)

Case contributed by Usman Bashir
Diagnosis certain

Presentation

Trauma

Patient Data

Age: Adult
Gender: Male

Measurement of different angles and lines in assessment of distal radial fractures (see text).

Case Discussion

Assessment of a distal radial fracture includes taking the following measurements :

  1. Radial height (AP): two lines perpendicular to the radial shaft are drawn. One is drawn along the articular surface and the second is drawn along the styloid tip. Normal (9.9mm - 17.3mm) <9mm suggests impacted fracture of the radial head.
  2. Radial inclination(AP): is the angle of the distal radial surface with respect to a line perpendicular to the shaft. A normal slope should be 15° - 25°
  3. Volar tilt (Lateral): is the angle of the distal radial surface with respect to a line perpendicular shaft. 10°- 25° is considered normal; a negative angle (zero in the case shown) indicates dorsal angulation.
  4. Ulnar variance: is the height of the ulnar height with respect to the radial articular surface. Normally 9 - 12mm, it is described as being zero, positive or negative and depends upon several factors including radiographic positioning. Equivocal cases should be compared with the contralateral side.

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