Distal Radius Fractures-Management of Severely Comminuted Distal Radius Fractures

Management of Severely Comminuted Distal Radius Fractures

Pdf Summary

Distal radius fractures are common fractures of the upper extremity. The management of these fractures has evolved over time, with different fixation techniques used depending on the type of fracture. Volar locking plates are commonly used for low-energy or uncomplicated fractures, but they are not suitable for highly comminuted fractures or polytrauma patients. Other methods, such as spanning fixation and fragment-specific fixation, have emerged as alternative options for these challenging fractures. <br /><br />The incidence of distal radius fractures is increasing, particularly in the elderly population. Medicare spending on distal radius fracture care has also increased over the years. In terms of diagnosis, assessment of the patient begins with a physical examination followed by radiographic imaging. Various classification systems exist to guide treatment decisions, based on the type and location of the fractures.<br /><br />Treatment of distal radius fractures aims to achieve adequate function and restoration of articular congruity. Casting alone can be an effective treatment option for certain fractures, particularly in older patients. Surgical treatment, such as internal fixation, can result in better outcomes in terms of radiographic parameters, but may not necessarily affect patient-reported outcomes.<br /><br />Different surgical techniques can be used for the management of distal radius fractures, including external fixation, dorsal plate fixation, volar plate fixation, bridge plating, and fragment-specific fixation. Each technique has its advantages and limitations and the choice of technique depends on several factors including the fracture pattern, patient characteristics, and surgeon expertise.<br /><br />Rehabilitation after surgery may involve range of motion exercises and the use of orthoses or casts. Postoperative rehabilitation is usually not necessary as home exercise programs can achieve similar outcomes. Overall, the goal of treatment is to restore articular congruity and achieve stable fixation to allow for early motion and maximize functional outcomes.

Keywords

distal radius fractures

fixation techniques

volar locking plates

comminuted fractures

polytrauma patients

classification systems

surgical treatment

rehabilitation

articular congruity

functional outcomes