Fractures Of Wrist and HandAngga Fiandana

Distal Radius Fractures

IntroductionDistal radius fractures occur through the distal metaphysis of the radius, frequently involving the ulnar styloid as well. Most often result from a fall on the outstretched hand. Associated injuries may accompany distal radius fractures.

IntroductionClassified by: presence or absence of intra-articular involvement, degree of comminution,dorsal vs. volar displacement,involvement of the distal radioulnar joint.

Treatment GoalsPreserve hand and wrist functionAvoid complicationsRestore anatomy where necessary and appropriate

Osseous AnatomyDistal radius 80% of axial loadDistal ulna 20%

AcceptabilityRadial inclination = 23 (13 -30 )Radial length = 11 (8-18) mmPalmar tilt = 0-28 (11-12)

Measurement of Radial Length and InclinationInclination = 23 degrees

Frykman ClassificationExtra-articularRadio-carpal jointRadio-ulnar jointBoth joints{Same pattern as right, except ulnar styloid also fractured

AO OTA ClassificationGroup A: Extra-articularGroup B: Partial Intra-articularGroup C: Complete Intra-articular

Dorsal angulation and comminution

Options for TreatmentCastingExternal FixationJoint-spanningNon joint-spanningPercutaneous pinningInternal FixationDorsal platingVolar platingCombined dorsal/volar plating

Indications for Closed TreatmentLow-energy fractureLow-demand patientNon-dominant handMedical co-morbidities