{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T23:00:10Z","timestamp":1785279610404,"version":"3.55.0"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In the management of articular distal radius fractures, achieving an accurate reduction of joint fragments is essential for a favorable prognosis. Fixation of the volar rim remains a surgical challenge, as volar plates may be improperly positioned despite adequate joint reduction.<\/jats:p>\n                  <jats:p>This study aims to analyze anatomical variations in the distal radius, focusing on the distance between the watershed line (WL) and the radiocarpal articular surface. These anatomical variations may partially explain the difficulty in achieving optimal plate placement during distal radius fracture fixation.<\/jats:p>\n                  <jats:p>We conducted a single-center study between October 2023 and May 2024, collecting three key measurements from computed tomography scans (CT scans) of healthy wrists. Based on distribution and correlation analyses, the wrists were categorized into two groups according to the distance from the most palmar point of the WL to the joint margin (SFWL). Group 1 included wrists with an SFWL \u2265 2.5\u2009mm, and group 2 included those with an SFWL\u2009&lt;\u20092.5\u2009mm. The 2.5\u2009mm threshold was selected based on the diameter of commonly used distal radius screws. This analysis revealed two emerging anatomical patterns. Then, four operators independently classified the CT scans as type 1 or 2 distal radius anatomy. Interoperators' variability was assessed using Cochran's Q test and Fleiss's kappa.<\/jats:p>\n                  <jats:p>A total of 100 wrists from 100 patients were included. Eighty-nine patients (89%) were classified in group 1 (SFWL \u2265 2.5\u2009mm), and 11 (11%) in group 2 (SFWL\u2009&lt;\u20092.5\u2009mm). In group 1, three patients (3.4%) showed a negative or zero value in the minimal distance from the WL (MDFWL) to the articular surface, indicating a high risk of intra-articular screw penetration. This risk was notably higher in group 2, with three patients (27.3%) exhibiting similar findings. Interoperator variability was strong, with a Fleiss's kappa of 0.73.<\/jats:p>\n                  <jats:p>Our findings suggest that the distal radius exhibits a spectrum of anatomical variation, which may contribute to suboptimal volar plate placement in some distal radius fractures. Recognizing these variations preoperatively may improve implant selection and reduce the risk of flexor tendon complications.<\/jats:p>\n                  <jats:p>Level IIIA.<\/jats:p>","DOI":"10.1055\/a-2678-7424","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T23:17:31Z","timestamp":1756855051000},"page":"337-344","source":"Crossref","is-referenced-by-count":0,"title":["How Should the Shape of the Volar Rim Be Taken into Account in the Treatment of Distal Radius Fractures? A Radiological Study"],"prefix":"10.1055","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6166-4463","authenticated-orcid":false,"given":"Jean-Baptiste","family":"de Villeneuve Bargemon","sequence":"additional","affiliation":[{"name":"Hand Surgery and Limb Reconstructive Surgery Department, La Timone Adult Hospital, Aix Marseille University, Marseille, France"},{"name":"Hand, Wrist and Elbow Surgery, Saint Roch Private Hospital, Toulon, France"},{"name":"International Wrist Center, Bizet Clinic, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Brenac","sequence":"additional","affiliation":[{"name":"Hand Surgery and Limb Reconstructive Surgery Department, La Timone Adult Hospital, Aix Marseille University, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emile","family":"Dobelle","sequence":"additional","affiliation":[{"name":"Hand Surgery and Limb Reconstructive Surgery Department, La Timone Adult Hospital, Aix Marseille University, Marseille, France"},{"name":"Department of Orthopedics and Traumatology ISM, CNRS, Institute of Movement and the Musculoskeletal System, Sainte-Marguerite Hospital, Aix-Marseille University, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Jaloux","sequence":"additional","affiliation":[{"name":"Hand Surgery and Limb Reconstructive Surgery Department, La Timone Adult Hospital, Aix Marseille University, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Prenaud","sequence":"additional","affiliation":[{"name":"Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Motel","sequence":"additional","affiliation":[{"name":"Avicenne Hospital, Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jht.2016.03.003","article-title":"Epidemiology of distal radius fractures and factors predicting risk and prognosis","volume":"29","author":"N J MacIntyre","year":"2016","journal-title":"J Hand Ther"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ocl.2017.12.001","article-title":"Evidence-based review of distal radius fractures","volume":"49","author":"B M Mauck","year":"2018","journal-title":"Orthop Clin North Am"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"77","DOI":"10.5435\/JAAOS-D-15-00525","article-title":"Complex distal radius fractures: an anatomic algorithm for surgical management","volume":"25","author":"P C Rhee","year":"2017","journal-title":"J Am Acad Orthop Surg"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"e2000010","DOI":"10.2106\/JBJS.RVW.20.00010","article-title":"Management of comminuted distal radius fractures: a critical analysis review","volume":"8","author":"J J Meaike","year":"2020","journal-title":"JBJS Rev"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.hcl.2005.02.008","article-title":"Essential radiographic evaluation for distal radius fractures","volume":"21","author":"R J Medoff","year":"2005","journal-title":"Hand Clin"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1016\/j.jhsa.2011.07.014","article-title":"Ligament contribution to patterns of articular fractures of the distal radius","volume":"36","author":"D G Mandziak","year":"2011","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1055\/s-0035-1570745","article-title":"Prevent collapse and salvage failures of the volar rim of the distal radius","volume":"5","author":"J L Orbay","year":"2016","journal-title":"J Wrist Surg"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1055\/s-0036-1581125","article-title":"Melone's concept revisited: 3D quantification of fragment displacement","volume":"8","author":"T Teunis","year":"2016","journal-title":"J Hand Microsurg"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1055\/s-0035-1571186","article-title":"Fragment-specific fixation for fractures of the distal radius","volume":"5","author":"W B Geissler","year":"2016","journal-title":"J Wrist Surg"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1055\/s-0043-1761286","article-title":"Does construct type matter? A Retrospective review comparing outcomes of distal radius fractures treated with standard volar plating versus fragment-specific fixation","volume":"12","author":"M Bowers","year":"2023","journal-title":"J Wrist Surg"},{"issue":"03","key":"ref11","first-page":"219","article-title":"Classification and management of failed fixation of the volar marginal fragment in distal radius fractures","volume":"11","author":"M C Orbay","year":"2021","journal-title":"J Wrist Surg"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-1782499","article-title":"Does hook type matter in articular distal radius fixation? Re. Does construct type matter? A retrospective review comparing outcomes of distal radius fractures treated with standard volar plating versus fragment-specific fixation","author":"J B De Villeneuve Bargemon","year":"2024","journal-title":"J Wrist Surg"},{"issue":"08","key":"ref13","doi-asserted-by":"crossref","first-page":"3419","DOI":"10.1007\/s00590-023-03558-2","article-title":"Operative treatment of distal radius fractures involving the volar rim-a systematic review of outcomes and complications","volume":"33","author":"A Lari","year":"2023","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1002\/jor.23125","article-title":"Interindividual anatomical variations affect the plate-to-bone fit during osteosynthesis of distal radius fractures","volume":"34","author":"H Yoneda","year":"2016","journal-title":"J Orthop 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