title: Trigonometry-Integrated 'Lift' Technique (TILT) for Restoring Volar Tilt in Distal Radius Fractures: Description of Technique and Preliminary Results.
abstract: BACKGROUND
  Restoration of extra-articular and intra-articular parameters are important considerations during operative fixation of distal radius fractures. Restoration of volar tilt by using visual estimation and the 'lift' technique has previously been described. The aim of our study was to describe a mathematical technique for accurately restoring the volar tilt of the distal radius to acceptable anatomic values.
  
  
  METHODS
  A retrospective review of cases performed using the trigonometry-integrated ' lift' technique (TILT) was performed. This technique uses the pre-operative volar tilt angle as well as the dimensions of the implant to calculate the 'lift' required to restore volar tilt. Intra-operative angles were measured using a marked transparency overlay on fluoroscopic images. Pre-operative and post-operative volar tilt were measured and analysed.
  
  
  RESULTS
  Twenty-seven fractures were included in the study, with 20 being classified as Arbeitsgemeinschaft für Osteosynthesefragen (AO) C-type. Pre-'lift' volar tilt ranged from 0° to -20°. Post-'lift' volar tilt ranged from 2° to 16°, with all but three cases ranging from 5° to 15°. The mean volar tilt achieved was 10.2°.
  
  
  CONCLUSIONS
  The trigonometry-integrated 'lift' technique resulted in reliable intra-operative restoration of anatomic volar tilt in distal radius fractures.
authors.affiliation: * Hand and Microsurgery Section, Tan Tock Seng Hospital, Singapore.
authors.forename: Sreedharan
authors.initials: S
authors.lastname: Sechachalam
authors.affiliation: * Hand and Microsurgery Section, Tan Tock Seng Hospital, Singapore.
authors.forename: Mala
authors.initials: M
authors.lastname: Satku
authors.affiliation: * Hand and Microsurgery Section, Tan Tock Seng Hospital, Singapore.
authors.forename: Jian Hao Kevin
authors.initials: JH
authors.lastname: Wong
authors.affiliation: † Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Lester Teong Jin
authors.initials: LT
authors.lastname: Tan
authors.affiliation: * Hand and Microsurgery Section, Tan Tock Seng Hospital, Singapore.
authors.forename: Fok Chuan
authors.initials: FC
authors.lastname: Yong
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D055641:Mathematical Concepts; D008875:Middle Aged; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies
keywords: Distal Radius Fixation; Distal Radius Fracture; Trigonometry; Volar Plating; Volar Tilt