Current Concepts in the Treatment of Distal Radial Fractures

Abstract

Distal radial fractures are among the most commonly encountered traumatic fractures of the upper extremity. Initial trauma mechanism, fracture pattern, associated injuries, and patient age influence treatment and outcome. Although stable fractures are commonly treated conservatively, the past decade has seen changes in surgical practice and techniques. Indications for surgery have been extended and refined based on new insight into the pathophysiology of the distal end of the forearm and technological advances in implant design. Despite the frequency of this fracture, only limited higher-level evidence exists to guide practitioners in decision making for this injury. This article highlights key concepts in the treatment of distal radial fractures and summarizes current evidence.

Transverse or longitudinal? A survey of volar wrist incision preferences

“…(3) In recent years, there has been an increasing trend towards minimally invasive surgical techniques. (4) One example is the minimally invasive percutaneous plate osteosynthesis technique for distal radius fractures, (5,6) which uses a transverse wrist incision. The procedure was found to have similar functional outcomes as the traditional longitudinal approach.…”

Intramedullary nailing and plating osteosynthesis in the correction of post-traumatic deformity in late-diagnosed distal radius fractures: a retrospective comparison study

“…Given the recent advances in the surgical intervention of distal radius fractures [1, 2], posttraumatic deformity that may lead to alternation of biomechanics of the wrist and function impairment in the hand and forearm [3–5] is still common sequelae in late-diagnosed fractures [6–8]. Loss of the normal volar tilt in the sagittal plane, decreased radial inclination in the frontal plane, and loss of radial height have been reported to be common deformities following extra-articular fractures [8].…”

Intrafocal Pinning for Dorsally Displaced Distal Radius Fractures

“…Fractures of the distal radius represent about 15% of all fractures seen in the emergency units and departments [1]. Different therapeutic methods have been described, and they all aim at achieving a sustained anatomic reduction and restoring the congruity of both the radio-carpal and radio-ulnar joints [2]. Although all methods intend to regain good functionality of the wrist and upper limb, there is still a lack of consensus regarding the optimal treatment method [2][3][4][5][6].…”

“…Different therapeutic methods have been described, and they all aim at achieving a sustained anatomic reduction and restoring the congruity of both the radio-carpal and radio-ulnar joints [2]. Although all methods intend to regain good functionality of the wrist and upper limb, there is still a lack of consensus regarding the optimal treatment method [2][3][4][5][6]. The surgical treatment of dorsally displaced distal radius fractures has recently evolved after the introduction of new generations of low-profile anatomic locking plates and screws [2].…”

“…Although all methods intend to regain good functionality of the wrist and upper limb, there is still a lack of consensus regarding the optimal treatment method [2][3][4][5][6]. The surgical treatment of dorsally displaced distal radius fractures has recently evolved after the introduction of new generations of low-profile anatomic locking plates and screws [2]. Among various surgical modalities, intrafocal pinning, first described by Kapandji in 1976 [7], has gained large popularity, especially in the French literature between 1980 and 2000.…”