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DISTAL RADIUS FRACTURE Lê Ngọc Quyên ATO Anatomy ATO inches (5cm) Mechanism Of Injury Children and old women: low energy trauma : simple fracture Young adult: high energy trauma : comminuted, intraarticular fracture Diagnosis  History  Physical exam: • open/closed • degree of soft tissue injury • neurovascular injury  Imaging Wrist PA, Lat CT scan MRI Radiographic Assessment Extensor carpi ulnaris tendon groove Smithuis: Supination/Pronation 100 DA changes 50 RA : Radial angulation(radial inclination, ulnar inclination…) RL : Radial length ( radial height ) Intra-articular gap or step DA : Dorsal angulation(volar tilt, palmar tilt, dorsal tilt…) UV : Ulnar variance RA RL DA UV Graham 220 12mm 110 -2mm LNQ 230 11mm 90 -0.8mm P mm b Radial angulation : < 15° c Dorsal angulation : > +150 d Intra-articular fracture step-off : < 1-2 mm Which of the following is true regarding the external fixation? a relies on ligamentotaxis to maintain reduction b usually combined with percutaneous pinning technique or plate fixation c cannot reliably restore dorsal angulation d all above A 32-year-old worker sustains a distal radius fracture Radiographs are provided below What is the appropriate treatment? a Closed reduction and long cast b Closed reduction and percutaneous pinning c Open reduction and plate fixation d Open reduction and external fixation Anwser: D D C