Algorithm for distal Radius fracture management
Jesse Jupiter,
Advances in Distal Radius Fracture Management - AAOS 1999
Fracture Classifications Relative to Operative Indications
-
Bending fractures (AO Type A) - When associated with neurologic deficit or seen late.
-
Shearing fractures (AO Type B) - definite indication
-
Compression fractures (AO Type C) - 4 part fracture with displaced volar lunate facet.
-
Radicarpal fracture-dislocation - frequent.
-
Comminuted complex fracture - common.
Algorithm
I. Bending Fractures
-
Manipulation & Cast usually
II. Shearing Fracture (AO Type B)
-
Volar
(AO Group B3). Vast majority will be split into two or more fragments (Jupiter et al,
Journal of Bone and Joint Surg
, 78A: 1996.)
-
Operative Approaches - Simple
-
Operative Tactics - buttress plate
-
Post-operative Management
-
-
Splint for two weeks, then active assisted range of motion
-
Results favorable: 31 excellent 10 good, 8 fair (Jupiter et al.,
JBJS
, 78A: 1996.)
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Specific Nerve Injuries & Tendon Transfers
