Diagnosis

Partial articular sagittal fracture of the radius

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Clinical examination

The patient should be evaluated for:

• Age
• Hand dominance
• Occupation
• Level of activity
• Quality of bone
• General medical condition

Options
1.  Simple fracture involving the scaphoid fossa
2.  Multifragmentary fracture involving the scaphoid fossa
3.  Fracture involving the lunate fossa

1.  Simple fracture involving the scaphoid fossa

Sagittal simple fracture involving the scaphoid fossa

These simple partial articular fractures involve the radial (lateral) column of the distal radius. These fractures demand accurate reduction since they involve the articular surface.

These are classified by AO/OTA as 2R3B1.1.

This fracture pattern is associated with a high incidence of injury to the scapholunate interosseous ligament (SLIL). They are shearing fractures of the joint surface.

Sagittal simple fracture involving the scaphoid fossa x-rays

2.  Multifragmentary fracture involving the scaphoid fossa

Sagittal multifragmentary fracture involving the scaphoid fossa

These fractures may also be multifragmentary. These are still classified by AO/OTA as 2R3B1.1.

Care must be taken to identify associated fractures extending into the palmar rim of the distal radius. These injury components are best visualized using CT scans.
These fractures are also often associated with scapholunate interosseous ligament injury.

Sagittal multifragmentary fracture involving the scaphoid fossa X-rays

3.  Fracture involving the lunate fossa

Sagittal fracture involving the lunate fossa

These partial articular fractures involve the ulnar column of the distal radius and therefore are intraarticular at both radiocarpal and distal radioulnar (DRUJ) joints.

These are classified by AO/OTA as 2R3B1.3.

Sagittal fracture involving the lunate fossa X-rays