Volar Lunate Facet Fractures of the Distal Radius: Fracture Mapping Using 3D CT Scans

被引:6
作者
Clarnette, Jock [1 ,2 ,3 ,4 ]
De Silva, April [3 ,4 ]
Eardley-Harris, Nathan [1 ,2 ]
MacLean, Simon [5 ]
Bain, Gregory I. [1 ,2 ]
机构
[1] Flinders Univ S Australia, Dept Orthopaed & Trauma Surg, Adelaide, SA, Australia
[2] Flinders Med Ctr, Adelaide, SA, Australia
[3] Royal Adelaide Hosp, Dept Orthopaed & Trauma, Adelaide, SA, Australia
[4] Univ Adelaide, Adelaide, SA, Australia
[5] Tauranga Hosp, Dept Orthopaed Surg, Tauranga, Bay Of Plenty, New Zealand
关键词
lunate facet fracture; distal radius; fracture mapping; classification; carpal instability; RIM FRACTURES; FIXATION;
D O I
10.1055/s-0041-1742228
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background Fractures of the distal radius involving the lunate facet at the volar articular surface are unstable injuries and are usually managed operatively. Management of these fractures is challenging as our understanding of the exact fracture characteristics and associated injuries to the carpus is poor. Purpose This study aims to define the anatomy and associated injuries of lunate facet fractures using three-dimensional computed tomography (CT) scans and fracture mapping techniques. Methods A consecutive series of CT wrists was analyzed to identify intra-articular fractures involving the lunate facet at the volar distal radius. Fractures were mapped onto standardized templates of the distal radius using previously described fracture mapping techniques. We also identified instabilities of the carpus including volar carpal translation, ulnar translocation, scapholunate diastasis, and distal radioulnar joint (DRUJ) instability. Results We present 23 lunate facet fractures of the distal radius. The lunate facet fragment displaces in a volar and proximal direction and the lunate always articulates with the displaced fragment. The smaller fragments displace a greater amount, in a volar direction, with pronation. The fracture tends to occur between the origin of the short and long radiolunate ligaments. Conclusion Lunate facet fractures are frequently comprised of osteoligamentous units of the distal radius involving the short and long radiolunate ligaments and the radioscaphocapitate ligament. Assessment and management of volar carpal subluxation, scapholunate instability, ulnar translocation, and DRUJ instability should be considered.
引用
收藏
页码:484 / 492
页数:9
相关论文
共 50 条
[41]   Comparison of fracture healing and long-term patient-reported functional outcome between dorsal and volar plating for AO C3-type distal radius fractures [J].
Sa-ngasoongsong, Paphon ;
Rohner-Spengler, Manuela ;
Delagrammaticas, Dimitri E. ;
Babst, Reto Hansjorg ;
Beeres, Frank J. P. .
EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY, 2020, 46 (03) :591-598
[42]   Radius distraction during volar plating of distal radius fractures may improve distal radioulnar joint stability at minimum 3-year follow-up: a retrospective case series study [J].
Yin, Cheng-Yu ;
Huang, Hui-Kuang ;
Fufa, Duretti ;
Wang, Jung-Pan .
BMC MUSCULOSKELETAL DISORDERS, 2022, 23 (01)
[43]   Skyline view versus intraoperative 3D fluoroscopy for dorsal screw protrusion identification following volar plating in the treatment of distal radial fracture [J].
Wung, Chih-Hsuan ;
Liu, Wen-Chih ;
Chiquiar, Lucia ;
Jupiter, Jesse B. ;
Regazzoni, Pietro ;
dell'Oca, Alberto A. Fernandez .
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2025, 20 (01)
[44]   3D deep learning for detecting pulmonary nodules in CT scans [J].
Gruetzemacher, Ross ;
Gupta, Ashish ;
Paradice, David .
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 2018, 25 (10) :1301-1310
[45]   Carpal lesions associated with dislocated fractures of the distal radius. A systematic screening of 104 fractures using preoperative CT and MRI [J].
Gologan, R. ;
Ginter, V. M. ;
Ising, N. ;
Kilian, A. K. ;
Obertacke, U. ;
Schreiner, U. .
UNFALLCHIRURG, 2014, 117 (01) :48-53
[46]   Epidemiology of distal radius fractures: Elucidating mechanisms, comorbidities, and fracture classification using the national trauma data bank [J].
Chinta, Sachin R. ;
Cassidy, Michael F. ;
Tran, David L. ;
Ceradini, Daniel J. ;
Bass, Jonathan L. ;
Agrawal, Nikhil A. .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2024, 55 (02)
[47]   Repositioning and stabilization of the radial styloid process in comminuted fractures of the distal radius using a single approach: the radio-volar double plating technique [J].
Jacobi, Matthias ;
Wahl, Peter ;
Kohut, Georges .
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2010, 5
[48]   Repositioning and stabilization of the radial styloid process in comminuted fractures of the distal radius using a single approach: the radio-volar double plating technique [J].
Matthias Jacobi ;
Peter Wahl ;
Georges Kohut .
Journal of Orthopaedic Surgery and Research, 5
[49]   Improving standard volar plate fixation in 3D-guided corrective osteotomy of the distal radius: evaluation of a shim instrument [J].
Gryska, Emilia ;
Libberecht, Katleen ;
Swinkels, Charlotte Stor ;
Axelsson, Peter ;
Fredrikson, Per ;
Bjorkman, Anders .
JOURNAL OF PLASTIC SURGERY AND HAND SURGERY, 2024, 59 :46-52
[50]   The correlation between intra-operative 2D-and 3D fluoroscopy with postoperative CT-scans in the treatment of calcaneal fractures [J].
Beerekamp, M. S. H. ;
Keizer, R. J. O. de Muinck ;
Schepers, T. ;
Beenen, L. F. M. ;
Luitse, J. S. K. ;
Schep, N. W. ;
Ubbink, D. T. ;
Goslings, J. C. ;
Segers, M. J. M. ;
Blokhuis, T. J. ;
de Jong, V. M. ;
Winkelhagen, J. ;
Twigt, B. ;
Maas, M. .
EUROPEAN JOURNAL OF RADIOLOGY, 2019, 112 :222-228