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Algorithm for distal Radius fracture management

Jesse Jupiter, Advances in Distal Radius Fracture Management - AAOS 1999

Fracture Classifications Relative to Operative Indications
  1. Bending fractures (AO Type A) - When associated with neurologic deficit or seen late.
  2. Shearing fractures (AO Type B) - definite indication
  3. Compression fractures (AO Type C) - 4 part fracture with displaced volar lunate facet.
  4. Radicarpal fracture-dislocation - frequent.
  5. 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.)
    1. Operative Approaches - Simple
    2. Operative Tactics - buttress plate
    3. 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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