Fracture lines and comminution zones in OTA/AO type 23C3 distal radius fractures: The distal radius map

Objective: This study was designed to define fracture lines and comminution zones in OTA/AO 23C3 distal radius fractures from axial computed tomography (CT) images that would influence surgical planning, development of new classifications, and possible implant designs. Methods: Thirty-four consecutive OTA/AO 23C3 fractures treated by a single surgeon between January 2014 and December 2014 were analyzed. For each fracture, maps of the fracture lines and zones of comminution were drawn. Each map was digitized and graphically superimposed to create a compilation of fracture lines and zones of comminution. Based on this compilation, major and minor fracture lines were identified and fracture patterns were defined. Results: All major fracture lines were distributed in the central region of the radius distal articular surface. There is a recurrent fracture pattern with a comminution zone including the scaphoid and lunate fossa; Lister’s tubercle; and ulnar, volar, and radial zones. Conclusion: It is important for the practicing surgeon to understand these four main fragments. Knowledge of this constant pattern should influence the development of new classifications and possible implant designs.