In Vivo changes in the lengths of carpal ligaments after mild dorsal angulation of distal radius fractures.

Abstract

The need for surgical correction in patients with malunion with mild dorsal angulation after a distal radius fracture is controversial. We specifically investigated in vivo changes in the lengths of carpal ligaments in a group of patients with mild-degree dorsal angulation following a distal radial fracture. We obtained computed tomography scans of both wrists in eight patients, whose distal radius on one side had united with dorsal angulation from 10° to 20°. The three-dimensional images of the carpus were reconstructed and the lengths of wrist ligaments were measured based on known anatomical landmarks. Compared with the contralateral uninjured side, the dorsal radiocarpal ligament and ulnotriquetral ligament were substantially lengthened (p < 0.05) and the long radiolunate ligament was substantially shortened (p < 0.05) at most wrist positions except extension. However, five other ligaments that we measured did not show significant differences in length compared with those of the uninjured side (p > 0.05). The lengths of some ligaments are substantially altered even by mild dorsal angulation of the distal radius, while the lengths of most other ligaments are not substantially affected.