Extensor tendon injury following osteosynthesis of distal radius fractures is a well documented complication. This has been shown to be associated with screw protrusion through the dorsal cortex, or plunging of the drill bit into the overlying tendon. It is often difficult to determine screw length and protrusion using the standard ante-roposterior and lateral intra-operative fluoroscopic images. This is in part due to the triangular configuration of the distal radius and Lister's tubercle. Many surgeons are using shorter screws and pegs to avoid this complication, however in coronal split fractures it may be necessary to capture the dorsal fragment to achieve a satisfactory reduction. For these fractures we use a novel radiographic view aimed along the long axis of the radius to detect screw protrusion. We present our early experience using this view and how it has changed intra-operative management.
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