The distal radial articular surface is the concave cartilage-covered face of the distal radius consisting of the scaphoid fossa laterally and the lunate fossa medially, separated by a central ridge. The articular surface is normally inclined 11-12 degrees palmarly and 22-23 degrees ulnarly, parameters that are restored during distal radius fracture reduction.
Restoring the palmar tilt and ulnar inclination of the distal radial articular surface is the primary goal of Colles fracture reduction and fixation. Loss of radial height and palmar tilt leads to carpal malalignment and wrist pain. Intra-articular step-off greater than 2 mm predicts post-traumatic wrist arthritis and requires surgical reduction. The articular surface is evaluated on CT for step-off and comminution before surgical planning.
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