Distal radius fractures occur through the distal metaphysis of the radius may involve articular surface frequently involving the ulnar styloid most often result from a fall on the outstretched hand. Distal radius fracture wrist fracture johns hopkins. A smith fracture is a fracture of the distal radius. The correct diagnosis and management of these fractures is crucial, as incorrect management may result in loss of normal wrist function, with significant implications on functional status and quality of life. Fracture usually occurs after a fall on an outstretched hand. In older people, the most common cause is falling on. Familiarity with wrist anatomy and the natural history of major fracture types is essential for appropriate management of distal radius fractures 2. Distal radius fractures broken wrist orthoinfo aaos. Symptoms include pain, bruising, and rapidonset swelling. A distal radius fracture occurs when a sudden force causes the radius bone, located on the thumb side of the wrist, to break. The classic presentation of a distal radial fracture is a fall onto an outstretched hand.
A 60yearold woman fell from a standing height, fractured her left distal radius, was splinted at an emergency room without reduction, and presented to the office six days after injury. Both bone forearm fracture pediatric pediatrics orthobullets. Plain film radiography reveals the distal radius and ulna fractures seen in image 2. The fractures occur through the distal metaphysis of the radius, with or without articular surface involvement. Dorsal approach and plating of a distal radius fracture 04. Do you want to use the redesigned ao sr like an app.
Proper management of distal radius fractures necessitates accurate fracture assessment, diagnosis, treatment, and evaluation of outcomes. It is important to realize that a distal radius fracture affects more than just the bone. A volar bartons fracture is a smiths type iii fracture. Distal radius fractures open reduction internal fixation case presentation and surgical technique. The part of the radius connected to the wrist joint is called the distal radius. Distal radius extraarticular fracture orif with volar. Many drfs will be seen and treated in the ed and then discharged to specialist follow up. Colles fracture specifically is defined as metaphyseal injury of cortico. Distal radius fracture management in elderly patients. Distal radius fracture colles fracture orthotrauma. Sld in distal radius fractures, should they be fixed. The radius is the most commonly broken bone in the arm. Most fractures are buckletype factures which are inherently stable and are treated with a removable splint for 3 weeks.
An orthopaedics textbook presented by duke university medical centers division of orthopaedic surgery, in conjunction with data trace internet publishing, llc, is a true head to toe, comprehensive discussion of orthopaedic topics. Fractures and dislocations of the carpus, in principles of hand surgery and therapy. The dorsal and radial cortices are thin and the volar and ulnar cortices are thick. The fracture extends proximally in a variable oblique direction from essentially transverse to almost sagittal from the distal radial articular surface through the lateral cortex of the distal radius, thus separating the radial styloid from the rest of the radius 4,5. Controversies in the management of distal radius fractures. It can be dorsal or volar depending on the direction of dislocation. Distal radius intraarticular fracture orif with dorsal. Association with distal radius fracture when radio ulnar joint is stable, seldom requires any independent treatment as it shows no impact on the anatomical, radiological or functional result. Patients may attend with displaced fractures or neurovascular problems which require urgent treatment and so appropriate initial assessment and.
Distal radial fracture radiology reference article. One of the most common distal radius fractures is a colles fracture, in which the broken fragment of the radius tilts upward. Such injuries account for approximately onesixth of fractures treated in united states emergency departments eds 1. Surgical correction of malunited fractures of the distal. Dorsal distraction plating for highly comminuted distal. Distal radius fractures are one of the most common injuries encountered in orthopedic practice. A fracture of the distal radius occurs when the radius near the wrist breaks. Distal radius fractures in older versus younger patients. Surgical techniques scaphoid nonunion orthobullets. The distal radius has metaphyseal flare and three articular surfaces. Kwires in distal row of plate will show anglelocation of distal screws. Distal radial ulnar joint druj injuries trauma orthobullets. Although often the fracture is undisplaced 5, depending on how sagittal the.
Distal radial fractures are a heterogeneous group of fractures that occur at the distal radius and are the dominant fracture type at the wrist. Isolated distal radioulnar joint druj dislocations with only ligamentous involvement are uncommon injuries. Overview distal radius fractures are the most common orthopaedic injury treatment is based on fracture pattern and stability. A fracture of the distal radius occurs when the area of the radius near the wrist breaks. The distal radius is the most common fracture site in the upper extremity. In 2009, the american academy of orthopaedic surgeons aaos established distal radius practice guidelines. Hematoma blocks for reduction of distal radius fractures. Common types of distal radius fractures everything you.
Orthobullets team % technique video 0 % technique steps 0. Distal radius extraarticular fracture orif with volar appr. Nondisplaced distal radius fracture torus fracture, buckle fracture immobilize in a short arm cast for 3 weeks. Please vote below and help us build the most advanced. A true lateral xray of the carpus to assess distal radialulnar joint alignment is recommended after reduction of any displaced distal radius fracture.
Distal radius fractures have long been a topic of fascination and investigation. Fracture of the distal radius including sequelaeshoulderhandfinger syndrome, disturbance in the distal radioulnar joint and impairment of nerve function. Distal radius and ulnar fractures musculoskeletal key. Therefore, the medical term for the most common type of broken wrist is a distal radius fracture that is, the larger forearm bone is broken near the wrist. Fractures of the distal radius are amongst the commonest fractures with which adult patients present to ed. In young people, for example, distal radius fractures are often caused by highenergy trauma that involves various combinations of bending, compression, impaction and shearing. Fractures of the distal radius represent a quarter of all fractures seen clinically. The break usually happens due to falling on an outstretched or flexed hand. Treating a distal radius fracture using spanning plate fixation feat. Radiographs revealed a comminuted intraarticular distal radius fracture drf with metaphyseal comminution and a complex articular fracture with both coronal. Removable splints have been used with similar outcomes to casting.
Frequently occur with distal radius fractures but must be considered independently. Radius and ulnar shaft fractures trauma orthobullets. Treatment of ulnar styloid fracture depends upon its association with distal radius fracture and triangular fibrocartilage complex tear. The ulna bone may also be broken in younger people, these fractures typically occur during sports or a motor vehicle collision. Patients trauma 46 year old male sustained injury from a fall while roller skating sustained markedly displaced, comminuted and impacted fracture of the left distal radius metaphysis with intraarticular extension. The break can occur in many different ways, however. Ulnar variance, or radioulnar length, can be calculated in a variety of ways, all of which yield similar results. Fracture of the distal radius is the most common fracture encountered by the orthopaedic trauma surgeon. Distal radius fractures have a bimodal distribution. Distal radius fractures open reduction internal fixation.
This is also a distal radius fracture but with an additional dislocation of the radiocarpal joint. The end of the radius bone toward the hand is called the distal end. The current custom error settings for this application. A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Your digital gateway to expertise, education, and innovation. In fact, the radius is the most commonly broken bone in the arm. In most cases, they are associated with a concomitant fracture, usually of the distal ulna or rarely of the distal radius. The radius is the larger of the two bones in the arm. Fracture distal radius salter iv hand surgery source. For example with a fracture with dorsally angulated fragments, establish axial traction, then slightly bending the dorsal fragment even more dorsally while maintain traction, then reverse pressure to reduce the distal fragment volarly and back out to length, all while maintaining traction. Your orthopedist is not in house and you will need to perform the reduction.
A distal radius fracture almost always occurs about 1 inch from the end of the bone. These injuries may result in fractures with metaphyseal comminution, and can, in some cases, cause extensive damage to the joint surface, fragmentation of the metaphysis. Distal radius fracture management in elderly patients remains without consensus regarding the appropriate treatment or anticipated outcome. The radius is one of two forearm bones and is located on the thumb side. The radius is the larger of the two bones of the forearm. Fractures of the distal radius are the most common fractures in children. Frykman classification of distal radial fractures uw. When the radius breaks near the wrist, it is called a distal radius fracture.
In consultation with your orthopedic colleagues by phone you determine that this fracture needs reduction and urgent outpatient follow up for consideration of operative fixation. Introduction a methodologic approach to the rehabilitation that follows distal radius fractures is presented based on knowledge of the biology of fracture healing, tissue healing, biomechanics of fixation, and biomechanics of splinting. Abraham colles is credited with description of the most common fracture pattern affecting distal end radius in 1814, and is classically named after him. A colles fracture occurs when the broken end of the radius tilts upward. Ulnar styloid fracturetreatmentexerciserehabcauses. These common fractures usually occur when significant force is applied to the distal radial metaphysis. Basically it is a colles or smiths fracture with dislocation.
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