Involvement of the palmar lunate facet in intra-articular distal radius fractures.

ABSTRACT

BACKGROUND: Small fracture fragments of the palmar lunate facet of the distal radius can be difficult to stabilize and may cause loss of reduction and even subluxation of the radiocarpal joint. MATERIAL & METHODS: The aims of the study were to investigate fracture patterns of the intermediate column in 101 intra-articular distal radius fractures with three-dimensional computed tomography, and to determine the prevalence of palmar lunate facet fracture fragments. The size of the fragments was measured to find out how many fragments were small. RESULTS: The palmar lunate facet fragment was present in 61 fractures. Mean length of the palmar cortex measured 13.5mm (range 3 to 26.9) and mean area of the lunate facet 115 mm2 (range 31 to 267). Seventeen percent of intra-articular distal radius fractures had a palmar lunate facet fragment with a short palmar cortex. CONCLUSION: With accurate analysis of the preoperative computed tomography scans the typical fracture patterns of the palmar lunate facet are recognisable and adequate fixation technique can be chosen to avoid loss of reduction. LEVEL OF EVIDENCE IV.