Die-punch fracture refers to a depression fracture of which distal radius facet?

Die-punch fracture refers to a depression fracture of which distal radius facet?

• A. Radial facet
• B. Scaphoid facet
• C. Lunate facet
• D. Ulnar facet

Answer: (C)

A die-punch fracture is a depression fracture of the lunate facet of the distal radius. It occurs when an axial load through the wrist drives the lunate into the radius, creating a crater-like depression in the lunate fossa that is typically intra-articular. This is why the lunate facet is the correct target: the pattern specifically involves the articular surface that articulates with the lunate. The other facets described in some texts either aren’t the site of this central depression pattern, or aren’t the primary contact point for this mechanism, so they don’t fit the characteristic injury. Radiographs or CT often show a central articular depression in the lunate fossa, and restoring articular congruity here is important to prevent post-traumatic arthritis.

A die-punch fracture is a depression fracture of the lunate facet of the distal radius. It occurs when an axial load through the wrist drives the lunate into the radius, creating a crater-like depression in the lunate fossa that is typically intra-articular. This is why the lunate facet is the correct target: the pattern specifically involves the articular surface that articulates with the lunate. The other facets described in some texts either aren’t the site of this central depression pattern, or aren’t the primary contact point for this mechanism, so they don’t fit the characteristic injury. Radiographs or CT often show a central articular depression in the lunate fossa, and restoring articular congruity here is important to prevent post-traumatic arthritis.