Theerachai Apivatthakakul, Jong-Keon Oh
It is important to assess the reduction quality correctly and repeatedly (to recognize intraoperative redisplacement).
The following displacement patterns should be identified:
For C-arm positioning to acquire optimal AP, lateral, and axial views, read the additional material on:
Read the fracture line on the image intensifier views. Identify gaps or increased density due to overlapping of fragments.
Follow the medial and the lateral cortical lines on the AP view and the anterior and posterior cortical lines on the axial view. Identify any translational and angular malalignment.
The cortical lines should show intact Lowell’s S-patterns (“lazy S”) in both views.
Acceptable reduction quality shows the following patterns:
In the AP view:
In the lateral view:
This case shows anatomical reduction in the AP and axial/lateral view with continuous cortical lines.
In the AP view, the fracture shows a shortening step in the medial cortex and a gap in the lateral cortex.
The axial view shows retroversion with a gap in the anterior cortex.