Distal Radius Fractures-Distal Radius Fractures: Overview

Distal Radius Fractures: Overview

Pdf Summary

Distal Radius Fractures are the most common fractures seen in emergency departments, with an incidence greater than 640,000 annually. They typically occur due to a fall on an out-stretched hand or high energy trauma. Physical examination should include evaluating for open wounds, associated injuries, and compartment syndrome. Acute carpal tunnel syndrome can also occur with these fractures and may require carpal tunnel release. There is no consensus on the classification system for these fractures, but they are generally based on articular involvement, number of fractures, and presence of an associated ulnar styloid fracture.<br /><br />Operative indications for these fractures include open fractures, fractures associated with acute carpal tunnel syndrome, compartment syndrome, or multiple injuries. Non-operative treatment can involve a splint or cast if no reduction is required. Closed reduction is performed under hematoma block with a sugar-tong splint. Age can impact the success of non-operative management, with increasing age decreasing the probability of maintaining an acceptable reduction.<br /><br />Operative techniques include closed reduction and percutaneous pinning, external fixation, bridge plating, and open reduction and internal fixation. Volar plating is associated with better outcomes and allows for reliable restoration of volar tilt. Dorsal plating has had historically high rates of extensor tendon irritation, but recent low-profile designs have similar rates to volar plates. Complications of operative management include extensor tendon rupture, flexor tendon rupture, and complex regional pain syndrome.<br /><br />Overall, the treatment approach for distal radius fractures depends on the specific characteristics of the fracture and patient factors such as age. Non-operative and operative techniques are available to achieve proper alignment and stability of the fracture site.

Keywords

Distal Radius Fractures

Emergency departments

Incidence

Fall on out-stretched hand

High energy trauma

Physical examination

Open wounds

Compartment syndrome

Carpal tunnel syndrome

Operative indications