A 60-year-old woman sustains a comminuted distal radius fracture. Post-reduction X-ray shows radial inclination of 10°, volar tilt of -10° (dorsal angulation), and radial shortening of 6 mm. These measurements indicate an acceptable reduction?
- A Yes — all values are within acceptable limits for conservative management
- B No — all three parameters are outside acceptable limits; surgical fixation is indicated ✓
- C Partially — only the dorsal tilt is unacceptable; the rest can be managed conservatively
- D Acceptable only in patients over 70 years of age
Correct answer: B. No — all three parameters are outside acceptable limits; surgical fixation is indicated
Explanation
Acceptable parameters for distal radius fracture reduction: radial inclination ≥15° (normal 22°); volar tilt ≥-10° to 0° (i.e., no more than 10° dorsal angulation) — some guidelines accept 0° to +11° volar; radial shortening ≤3 mm. In this case: radial inclination 10° (< 15° = unacceptable), volar tilt -10° (dorsal angulation = borderline/unacceptable), radial shortening 6 mm (>3 mm = unacceptable). All three criteria fail; surgical ORIF with volar locking plate is indicated especially in an active 60-year-old.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.