DISTAL RADIUS FRACTURE.pptx

fravture

1. DISTAL RADIUS FRACTURE

2. Colles fracture Described as a “dinner fork” deformity. More than 90% of distal radius fractures are of this pattern Mechanism of injury is a fall onto a hyperextended, radially deviated wrist with the forearm in pronation. Intra-articular fractures are generally seen in the younger age group secondary to higher energy forces DISTAL RADIUS FRACTURES

3. Smith fracture (reverse Colles fracture) Fracture with volar angulation (apex dorsal) of the distal radius with a “garden spade” deformity. Mechanism of injury is a fall onto a flexed wrist with the forearm fixed in supination. Notoriously unstable fracture pattern; it often requires open reduction and internal fixation DISTAL RADIUS FRACTURES

4. Basic Baby Care NONOPERATIVE Indications: Nondisplaced or minimally displaced fractures Displaced fractures with a stable fracture pattern which can be expected to unite within acceptable radiographic parameters Low-demand elderly patients in whom future functional impairment is less of a priority than immediate health concerns and/or operative risks OPERATIVE Indications: High-energy injury Secondary loss of reduction Open fractures Displaced shear fractures (type II) Comminuted and displaced articular fractures with articular impaction (type III) Fracture–dislocations (type IV) Combined injuries with metaphyseal – diaphyseal comminution (type V) Fractures complicated by nerve compression, compartment syndrome , or multiple injuries Bilateral distal radius fractures An impaired contralateral extremity TREATMENT

5. NONOPERATIVE Technique of closed reduction (dorsally tilted fracture) The distal fragment is hyperextended. Traction is applied to reduce the distal to the proximal fragment with pressure applied to the distal radius. A well-molded long arm (“sugar-tong”) splint is applied, with the wrist in neutral to slight flexion. Studies have demonstrated the ability of short arm splints to accomplish the same goal with improved patient satisfaction. One must avoid extreme positions of the wrist and hand. The splint should leave the metacarpophalangeal joints free. Once swelling has subsided, a well-molded cast is applied. The cast should be worn for approximately 6 weeks or until radiographic evidence of union has occurred. The ideal forearm position, duration of immobilization, and need for a long arm cast remain controversial; Extreme wrist flexion should be avoided because it increases carpal canal pressure (and thus median nerve compression

6. Reference Campbell’s Operative Orthopaedics , 4-Volume Set 14th Edition (2020)  Hoppenfeld Surgical Exposures in Orthopaedics : The Anatomic Approach 5th Edition (2016 ) Apley’s System of Orthopaedics and Fractures Ninth Edition, 2010