Distal radius fracture is one of the most common fractures seen by orthopaedic surgeons, with an incidence of 195. Because the palmar surface of the distal radius is originally flat, application of a flat plate onto this surface was a good way to correct malrotations of the fractures in many cases. Over the age of 50 years, likely due to the effects of osteo porosis, distal radius fractures are more com mon in women. Displaced fractures of the ulnar styloid base associated with a distal radius fracture result in instability of the druj and resulting loss of forearm rotation. Distal radius fractures orthopaedic trauma association.
Amsterdam pediatric wrist rules may be used to guide decision making in obtaining radiographs in patients presenting with pain after wrist trauma but 23v wrist radiographs are the definitive. Nerve injury, especially of the median nerve and presenting as carpal tunnel syndrome, is commonly reported following distal radius fractures. If there is clinical instability after radius fixation the ulnar styloid base fracture or druj needs to be stabilized. Do the wristforearmthumb exercises 3xday out of your splint. Axial shortening of the radius by less than 3 mm, designated grade 0, was considered acceptable. Distal radius fractures are those which by definition occur about one inch from the end of the bone. For complete metaphyseal displaced fractures and fractures involving both the radius and ulna, the need for close followup should be emphasised due to the risk of loss of. Distal radius wrist fracture surgery home program phase 2. Distal radius wrist fracture surgery home program phase 3 exercises david gesensway, md you will begin these exercises approximately 4 weeks after surgery, once the doctor has examined your x ray and cleared you for strengthening and passive stretching exercises. Instruments and implants approved by the ao foundation. A distal radius fracture almost always occurs about 1 inch from the end of the bone. Pdf fractures of distal radius account for up to 20% of all fractures treated in emergency department. Objective closed reduction and percutaneous pinning crpp is losing popularity as a treatment modality for distal radius fractures.
Distal radial fracture radiology reference article. Distal radius fracture drf is the most common fracture encountered in clinical practice. Bartons fracture is a displaced, unstable, articular fracturesubluxation of the distal radius with displacement of the carpus along with the articular fracture fragment. Distal radius fracture an overview sciencedirect topics. The most commonly broken bone in the wrist is the radius bone. Management of these fractures is still a challenge for. Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Fractures and injuries of the distal radius and carpus. Review of anatomy, common fractures of the distal radius, fixation methods, and precautions understanding the therapeutic approach for acute care and outpatient management of distal radius fractures special considerations in distal radius fracture management. This fracture was first described in 1814 by an irish surgeon and anatomist, abraham colles hence the name colles fracture.
Distal radius fractures are common and comprise 15% of extremity fractures. Distal metaphyseal fractures of the radius have very good remodelling potential because of the proximity to the growth plate. Good or excellent functional results occurred in 96% of their patients. Do you want to use the redesigned ao sr like an app. Fractures of the distal ulna associated with fracture of. Distal radius fracture orif rehabilitation protocol. Distal radius fractures are some of the most common fractures the medical term for broken bone.
Distal radius buckle fractures are common in children and typically present after a fall on an outstretched hand. Mammoth orthopedic institute 85 sierra park road mammoth lakes, ca 93546 760. Distal radial fractures can be seen in any group of patients and there is a bimodal age and sex. Please fax initial evaluation and progress notes to 815. This article discusses the recovery process for both approaches, plus the pain management tactics that can be used for all patients. Grade 1 included fractures with 3 to 5 mm of shortening. To study the functional outcome of displaced distal radius fractures treated by open reduction and internal fixation with the use of fragmentspecific fixation.
These common fractures usually occur when significant force is applied to the distal radial metaphysis. Fracture of distal end of radius continues to be one of the most common skeletal injuries since the description by poteau in 1783 and by colles in 1814. Classifications systems are devised to describe patterns of injury which will behave in predictable ways, to distinguish between conditions which have different outcomes or which need different treatments. We aimed to retrospectively assess the outcomes after crpp for the treatment of distal radius fractures. Pdf management of fracture of distal radius by external. Recovering from a distal radius fracture sportshealth. Surgical correction of malunited fractures of the distal. Current trends in the management of distal radius fractures. Classification of distal radius fractures wikipedia. This document is intended as an outline for the surgical technique of the repair of the distal radius. Do not do any weightlifting or strengthening exercises without. The illuminoss system is indicated for use in fracture alignment reduction. The width of this angle influences the localization of the fracture.
Risk factors for complications after locked volar plate fixation. Distal radius fractures open reduction internal fixation case presentation and surgical technique dorsal approach and plating of a distal radius fracture david tuckman, m. Treatment options include conservative management, internal fixation with pins. Distal radius fractures common injury fractures of the distal radius represent approximately 16% of all fractures treated by orthopaedic surgeons three main peaks of fracture distribution. Distal radius fracture, first described by abraham colles in 1814, is a com mon injury seen in most emergency rooms. Orthopedics this article discusses recent reports on distal radius fractures. Evidence from two or more low strength studies with consistent findings, or evidence from a single moderate quality study recommending for or against the intervention or diagnostic.
Colles fractures occur proximal to the distal radioulnar joint. External fixation is more suitable for intraarticular. Distal radius fractures broken wrist orthoinfo aaos. Distal radius fractures are generally caused by a fall on an outstretched hand. Covers distal radius fractures from imaging and classification to the new locking plate designs, emerging nonplate alternatives such as intramedullary and tpin fixation, and newer nonbridging external fixators for intraarticular fractures to provide you with the latest developments in the field. Volar plate fixation of distal radius fractures jorge orbay, md miami hand center, 8905 southwest 87 avenue, suite 100, miami, fl 33176, usa reliable internal. Distal radius fracture orif activity you may not bear weight with your affected arm until cleared by your physician. 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. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Distal radius fracture orif this is a surgical video. The bony anatomy involves the distal radius, distal ulna and carpal bones. F, torrance, ca 90503, usa watsonjones pointed out that a fracture is a soft tissue injury that happens to involve. 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 fractures occur through the distal metaphysis of the radius.
The injuries occur when the wrist is subject to nonphysiologic loads, such as falling on an outstretched hand. Variable angle lcp twocolumn volar distal radius plate 2. Distal radius fractures can be treated without surgery if the fragments are minimally displaced, meaning that the fragments remain in close connection and do not cause unevenness of the distal radius joint surface. With new techniques in management of the distal radius leading to near anatomic restoration of distal radius alignment, druj instability seems to be less common. A fracture with more than 5 mm of radial shortening at the druj was termed grade 2. Trimed fixation system for displaced fractures of the. May involve articular surface frequently involving the ulnar styloid. Each chapter offers a comprehensive guide to the diagnosis and treatment of a specific fracture, including possible complications. Therapist management of distal radius fracture october 18, 2019 cindy quinnelly, ms, otrl, cht 1. Distal radius fractures often occur as a result of a fall on an outstretched hand. Hutchinson fracture, fracture of radial styloid, is not shown and is best seen on frontal or oblique view. The form and severity of fracture of distal radius as well as the concomitant injury of discoligamentary structures of the wrist also depend on the position of the wrist at the moment of hitting the ground. Patients with a distal radius fracture generally present with a history of recent trauma with subsequent pain, swelling, ecchymosis, and often an obvious deformity of the affected wrist. As one of the most common fractures seen by orthopaedic surgeons, distal radius fractures result in significant financial burden.
Your digital gateway to expertise, education, and innovation. The radius is the forearm bone on the thumb side in the x ray above, it is the one on the right. Distal radius wrist fracture surgery home program phase 2 exercises david gesensway, md you will start these exercises 57 days after surgery, at your first hand therapy visit. Distal radius fractures can be reset either with surgery open reduction or without it closed reduction. There are a number of ways to classify distal radius fractures. However, in select cases, crpp may have advantages relative to open reduction and internal reduction. A transverse, extraarticular fracture of the distal radius distal 2cm of the radius that is angulated dorsally and impacted by the proximal carpal row the scaphoid and lunate, caused by a fall on an outstretched hand. The finger exercises can be done in the splint, every 2 hours. Every year, more than 20000 people in sweden suffer from this injury. It provides stabilization for bone fractures using a minimally invasive technique in which the bone is not subjected to significant weight bearing forces. Distal radius fracture is the medical term for a broken wrist. Distal radial fractures are a heterogeneous group of fractures that occur at the distal radius and are the dominant fracture type at the wrist. Atlas of distal radius fractures free pdf download. If your surgeon decides that the fracture can be treated without surgery, a.
One of the most common distal radius fractures is a colles fracture, in which the broken fragment of the radius tilts upward. The scope of this discussion will be limited to the more common entities, such as pediatric forearm and distal radius fractures, and will not include articular fractures, plastic deformation, and fracture dislocations, such as monteggia lesions. Slutsky, md, frcsc, mojca herman, ma, otrl, cht 3475 torrance blvd. Client centered approach to distal radius fracture management. Surgical technique this publication is not intended for distribution in the usa.
While the volar approach is by far the preferred approach when fixing most distal radius fractures the dorsal. Therapy after a distal radius fracture can last as long as 3 months. The break can occur in many different ways, however. Information for patients this is a followup leaflet to your recent telephone consultation with the fracture care team explaining the ongoing management of your injury. Distal radius fractures scott wolfe md upper extremity surgeon. The use of removable splints is an option when treating minimally displaced distal radius fractures. Ae, drawings show normal distal radius in lateral projection with dorsal surface to right a, colles fracture b, smith fracture c, dorsal barton fracture d, and volar barton fracture e. These, according to their displacement or tracing of the. The keyword distal radius fracture was used to query the pubmed database of the us.
Intraarticular component in distal radius fractures usually signifies highenergy trauma. Overview distal radius fractures are the most common orthopaedic injury treatment is based on fracture pattern and stability. For fragmentspecific fracture fixation with variable angle locking technology. This document addresses the treatment of acute distal radius fracture in adults. Distal radius fractures are the most common fractures seen in the emergency department. Distal radius wrist fracture surgery home program phase 3. You should move straighten and bend your fingers at least 10 times per day within your comfort to decrease swelling and prevent. A distal radius fracture occurs when a sudden force causes the radius bone, located on the thumb side of the wrist, to break. Distal radius fracture orif rehabilitation protocol kelly holtkamp, m. As your fracture heals and you become more familiar with your home exercise program, you will have therapy 1 time a week, and then once every 2 weeks until you have gained good range of motion and strength. It involves an intraarticular fracture of radial styloid of variable size.