Distal radius fluoroscopic skyline view: extension–supination versus flexion–supination

  • Laëla El Amiri
  • Yuka Igeta
  • Chiara Pizza
  • Sybille Facca
  • Juan José Hidalgo Diaz
  • Liverneaux PhilippeEmail author
Original Article • WRIST - IMAGING


The aim of our study was to compare the vertical fluoroscopic view of the wrist in extension and supination (ES) to the view in flexion and supination (FS) and determine which of the two views allowed the best visualization of four selected anatomical landmarks SDLR (radial styloid, dorsal radius cortex, Lister’s tubercle and distal radioulnar joint). Our case series included 50 patients who had suffered a distal radius fracture and undergone an open reduction and internal fixation procedure with a volar locking plate. For each case, two fluoroscopic views were taken: ES (wrist extension and supination) (group I) and FS (wrist flexion and supination) (group II). Ten observers had to recognize the SDLR anatomical landmarks on 100 fluoroscopic skyline views (time 1) and 15 days later (time 2). The rate of recognition of the four anatomical landmarks was 78% in group I and 66% in group II (p < 0.001). The concordance rate of recognition of the four anatomical landmarks was mediocre (κ = 0.411). In conclusion, the vertical fluoroscopic skyline view in wrist extension and supination seems to be the most adequate view to assess the quality of the fracture reduction, the distal radioulnar joint and the length of the screws in open reduction and internal fixation of distal radius fractures with volar locking plates.


Skyline Dorsal tangential view Distal radius 



François Séverac, Pôle de Santé publique, Secteur méthodologie et Biostatistiques, Hôpitaux Universitaires de Strasbourg, qui a réalisé l’étude statistique.

Compliance with ethical standards

Conflict of interest

Philippe Liverneaux has conflicts of interest with Newclip Technics, Argomedical, Zimmer Biomet and Biomodex. None of the other authors have conflicts of interest.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Laëla El Amiri
    • 1
  • Yuka Igeta
    • 1
    • 2
  • Chiara Pizza
    • 1
  • Sybille Facca
    • 1
  • Juan José Hidalgo Diaz
    • 1
  • Liverneaux Philippe
    • 1
    • 3
    Email author
  1. 1.Department of Hand Surgery, SOS Main, CCOM, University Hospital of Strasbourg, FMTS, Icube CNRS 7357University of StrasbourgIllkirchFrance
  2. 2.Department of Orthopedic SurgeryJuntendo UniversityTokyoJapan
  3. 3.Hand Surgery DepartmentStrasbourg University HospitalsIllkirchFrance

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