Volar tilt

Last revised by Leonardo Lustosa on 14 Sep 2022

Volar tilt, or palmar tilt, is an important measurement in the evaluation of distal radius fractures and radial deformities.

The volar tilt is assessed on the lateral radiograph of the wrist, it corresponds to the angle formed by a line drawn perpendicular to the axis of the radial shaft, and a line that passes through the tips of the dorsal and volar rims (i.e. along the radius articular surface) 1,2,5-8.

  • normal: 7-15º 5-7, an average of 11º 1-8 - some authors consider the normal range 2-20º 4,8
  • >10º of dorsal tilt is related to worse outcomes 9,10
  • >20º of volar tilt is related to unstable fractures and worse outcomes 5,10
  • >25º of volar tilt can contribute to dorsal intercalated segment instability (DISI) 9 

The term dorsal tilt is sometimes used if the angulation is dorsal rather than volar, negative values of volar tilt can be used instead to indicate a dorsal angulation.

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