Intraarticular fractures of the distal radius: a cadaveric study to determine if ligamentotaxis restores radiopalmar tilt.

Nineteen fresh cadaver wrists were divested of all dorsal and palmar tissues to the wrist capsule and extrinic and intrinsic ligaments. A Frykman VII type fracture was established across the radiocarpal and radioulnar joints. The dorsal and palmar wrist ligaments were left intact. The forearms were stabilized in an arm board and an external fixation device and traction applied through a Kirschner wire at the base of the third metacarpal. Three positions of wrist flexion; neutral, 15, and 30 degrees, with 10 and 20 pounds of traction were used to attempt to reestablish radiopalmar tilt. Only when the entire palmar ligamentous structures were transected at the radius was radiopalmar tilt reestablished. Ligamentotaxis alone is not a reliable method to reestablish radiopalmar tilt in intraarticular distal radius fractures.