Scientific articleReliability and Clinical Importance of Teardrop Angle Measurement in Intra-articular Distal Radius Fracture
Section snippets
Definition of TDA
On standard and 10° tilt views of the lateral wrist radiographs, we identified the teardrop, representing the volar rim of the lunate facet. A line drawn along the central axis of the teardrop (parallel to the subchondral bone of the volar rim) created a TDA with a line extending from the central axis of the radial shaft (Fig. 1B). The central axis of the teardrop was defined as a tangential line of a circle that matched the arc of the articular surface of the volar lunate facet and passed
Results
On the lateral projection, UV averaged 0 mm in non-fractured wrists and 2 mm in fractured wrists. RI averaged 26° and 16°, respectively, and VT averaged 17° and 0°, respectively. The VT in 10° tilt views from the lateral projection was a mean of 13° in non-fractured wrists. The TDA on the lateral wrist projection was a mean of 55° in non-fractured wrists and 43° in fractured wrists. The TDA in 10° tilt views was a mean of 64° in non-fractured wrists (Table 1).
Interobserver and intra-observer
Discussion
Fractures of the distal radius involving the volar lunate facet, as described initially by Melone,13 are among the more difficult articular fractures to treat effectively. Failure to reduce and stabilize the lunate facet during open reduction and internal fixation has been shown to result in poor functional and radiographic outcomes.14, 15 On the lateral view of the plain radiographs, the teardrop represents the volar rim of the lunate facet. Because the central axis of the lunate is normally
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2021, Orthopedic Clinics of North AmericaCitation Excerpt :Harness and colleagues37 reported 7 patients who lost fixation of the volar lunate facet resulting in carpal subluxation; 5 required revision fixation. The teardrop angle, the angle subtended by the central portion of the tear drop and the radial shaft, has been used to assess the lunate facet in intra-articular fractures on the 10° tilt lateral radiograph.38,39 The narrow width and rapid transition to the volar surface of the lunate facet make plate fixation and screw purchase difficult within this fragment.40
Radiographic Parameters of Distal Radius Fractures
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2014, Journal of Hand SurgeryCitation Excerpt :If the angle is less than 45°, this suggests marked dorsal tilt of the volar rim.4 The teardrop angle has high interobserver and intra-observer reliability, and it has been associated with articular gap and stepoff on computed tomography.5 Preoperative computed tomography scans are also helpful for delineating fracture fragments and identifying fragment morphology.6
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