Palmar tilt of the distal radius: influence of off-lateral projection  initial observations.
OBJECTIVE
To evaluate the effect of slight off-lateral positioning of the wrist on measurements of the palmar tilt of the distal radius on lateral views and to determine how this effect can be corrected quantitatively.


METHODS
Seven cadaveric forearms in neutral and various oblique positions (5 degrees, 10 degrees, 15 degrees, 20 degrees ) of supination and pronation were examined with lateral radiography. The palmar tilt of the distal radius measured on the radiographs was correlated with each position of the wrist and the distance between the position of the palmar cortex of the pisiform bone (P) and a reference point (point 0), which was defined as the midpoint within the interval between palmar cortices of the distal scaphoid pole and of the capitate head (P0 distance). The same measurements were performed on 11 wrists during arthrography.


RESULTS
The apparent palmar tilt of the distal radius increased with supination of the forearm. Regression analysis with the P0 distance as independent and palmar tilt as dependent variables resulted in a slope of 0.95 in the seven cadaveric wrists and of 0.92 in the 11 wrist arthrograms. The squares of the correlation coefficients (R(2)) were 0.89 in cadaveric wrists and 0.69 in 11 wrist arthrograms.


CONCLUSIONS
Differences in the palmar tilt produced by off-lateral projections of the wrist can be estimated from the measured difference of the P0 distance. A 1-mm difference in the P0 distance corresponds to a difference in the palmar tilt of approximately 1 degrees.
Zanetti
M
M
Department of Radiology, Orthopedic University Hospital Balgrist, University of Zurich, Forchstrasse 340, CH-8008 Zurich, Switzerland. marco.zanetti@balgrist.ch
Gilula
L A
LA
Jacob
H A
HA
Hodler
J
J
D000328:Adult; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011403:Pronation; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging*; D011885:Radius Fractures / Q000000981:diagnostic imaging; D012399:Rotation; D013484:Supination; D014955:Wrist Joint / Q000000981:diagnostic imaging