Palmar plate fixation is a very common surgical procedure for distal radius fractures, especially for unstable fractures with palmar displacement. Placing the plate on the palmar side of the distal radius reduces the risk of extensor tendon provocation, which is the most significant disadvantage of dorsal plating. However, irritation or injury to the dorsal tendon occurs in 2-6% of patients with a palmar plate, mainly due to penetration of the tip of the screw in the palmar plate into the dorsal cortex. A depth gauge is usually used intraoperatively to determine the length of the screw, but in special cases such as dorsal cortical crush, it is often difficult to accurately determine the depth of the screw hole. Moreover, on conventional frontal and lateral images of the wrist, even if the screw penetrates the cortex, it may not be visible due to the complex three-dimensional structure of the distal radius (Lister’s node, etc.). There are also several clinical methods to determine the length of the screw. For example, Maschke et al. described an anterior and posterior rotational lateral oblique image, which is easier to detect screws penetrating the dorsal cortex than the standard frontal lateral view, but the length of screw penetration must be at least 2-4 mm to be detected. Professor Haug et al. from the Medical University of Innsbruck, Austria, performed a cadaveric imaging study and confirmed that dorsally inclined axial views of the distal radius clearly show the true length of screws and avoid screw penetration through the dorsal cortex, and the results were published in the August 2013 issue of the BJJ journal (JBJS [Br] has been renamed). The researchers fixed six cadaveric specimens of the distal radius with Synthes’ 2.4-mm palmar locking plate. Screws were placed under direct vision, with the ideal screw length being the length at which the tip of the screw lies just below the contralateral cortex and has not yet penetrated the cortex (another dorsal approach was made and confirmed under direct vision.) The four screws were numbered individually from the radial to the ulnar side, and the specimens were fixed vertically with extreme posterior rotation and wrist flexion using the method shown in Figure 1. α-angle radiographs were taken starting at 0 degrees (vertical) and at 5-degree intervals until 45 degrees.