An anatomic description of the fracture is the easiest way to describe the fracture, determine treatment, and assess stability. * Articular incongruity * Volar or dorsal tilt * Radial inclination * Radial length and ulnar variance * Comminution of the fracture (the amount of crumbling at the fracture site) * Open (compound fracture) vs. closed injury * Associated ulnar styloid fracture * Associated soft tissue injuries Articular incongruity The articular joint's surface must be smooth for it to function properly. Irregularity may result in radiocarpal arthritis, pain, and stiffness. More than 1 mm of incongruity places the patient at a high risk for post-traumatic arthritis. Significant articular incongruity typically occurs in young patients after high energy injuries. If the surface is very irregular and cannot be reconstructed, then the only option may be a fusion of the joint. Volar vs dorsal tilt A dorsal tilt of a<unk><unk>  fracture is shown in in image at right. The angulation goes between: # A line drawn between the<unk>  ends of the articular surface of the<unk>  on a lateral X-ray. # A line that is perpendicular to the diaphysis of the<unk> . Sometimes, the diaphysis of the<unk>  is hard to distinguish from the ulna, and a line between them ( in image) may be used instead. Fracture with a decreased radial inclination (about 15°). The angle normally has volar tilt of 11° to 12°. The most common fracture pattern usually demonstrates malalignment of this angle and collapse in a dorsal direction. A dorsal tilt of 0° (11° - 12° deviation from normal anatomic position) causes a substantial risk of developing pain and impaired function. After closed reduction, a residual dorsal tilt of a maximum of 5° (16° - 17° deviation) is regarded as the maximal residual angle for a satisfactory result. Radial inclination The radial inclination of a<unk><unk>  fracture is shown in in image at right. The angle is measured between: # A line drawn between the<unk>  ends of the articular surface of the<unk>  on an AP view of the wrist. # A line that is perpendicular to the diaphysis of the<unk> . Radial inclination is normally 21-25°. Radial length and ulnar variance Radial length is an important consideration in<unk><unk>  fractures. Radial length should be between 9-12mm.<unk><unk>  fractures typically result in loss of length as the<unk>  collapses from the loading force of the injury. With increasing relative lengthening of the uninjured ulna (positive ulnar variance), ulnar impaction syndrome may occur. Ulnar impaction syndrome is a painful condition of excessive contact and wear between the ulna and the carpus with an associated is a degenerative tear of the TFCC.none
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Pressure immobilisation technique
Knee examination
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