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桡骨远端骨折

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Distal radius fractures — assessment, casting, and indications for surgical fixation.

Updated Jun 2026
一幅手绘插图，描绘了一个无脸的人向前摔倒，手掌撑地，手腕承受冲击力。
移位性桡骨远端骨折的X线影像——最常见的成人骨折类型。前臂骨的远端在腕关节上方发生断裂并移位，导致对位不良。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您的手腕和前臂在骨折部位可能会感到疼痛。这种疼痛起初通常很剧烈，随后转为深层的酸痛。您可能会注意到肿胀和瘀伤向下蔓延至手部。您的外科医生的主要目标是预防该损伤引起的并发症。早期诊断和治疗对于避免长期后果至关重要。

简单的动作可能会变得困难。您可能难以将手伸到背后扣上胸罩。塞衬衫或转动门把手时可能会感到僵硬或疼痛。即使提起轻物也可能引发疼痛加剧。您的外科医生将致力于恢复骨骼的正常形态。这有助于您恢复功能并随着时间的推移减轻疼痛。

疼痛可能在夜间或白天活动后加重。随着愈合的进展，有些日子感觉比另一些日子好。虽然骨骼愈合是主要关注点，但软组织问题也可能引起不适。这些问题包括肌腱刺激或神经敏感。在极少数情况下，会出现复合神经问题，但这极为罕见。您的外科医生将密切监测这些区域。

您可能会担心长期的僵硬或关节炎。某些韧带损伤若未得到治疗，延迟诊断可能导致在10年内发生关节炎。然而，通过适当的护理，大多数人恢复良好。骨骼不愈合的风险极小。您的外科医生可能会使用特定的技术来稳定骨折。这些方法旨在提供结构稳定性，并帮助您更早地恢复日常活动。

避免忍受剧烈疼痛。如果出现突然的麻木、刺痛或肿胀加重，请联系您的护理团队。这些可能是软组织并发症的迹象。您的外科医生将指导您进行安全的动作。休息手臂并将其抬高有助于管理肿胀。遵循您外科医生的建议，在适当的时候开始进行轻柔的活动。这种平衡既能保护愈合中的骨骼，又能保持关节的活动度。

实际发生了什么

桡骨远端骨折是前臂靠近腕部的大骨发生的断裂。该区域是手部至关重要的减震器。当您摔倒时手掌撑地，冲击力会沿手臂上传并可能导致该骨骼断裂。骨折通常会导致骨端移位，这一过程称为移位。这种错位会破坏关节的光滑表面，导致活动疼痛和僵硬。

您的外科医生的主要目标是恢复腕部的自然形态和对齐。可以将您的腕关节想象成门上的铰链。如果门框弯曲，门将无法正确关闭或摆动。同样，如果桡骨没有正确对齐，您的腕关节将无法顺畅运作。最佳结果取决于恢复并维持这种解剖学对齐。这确保了骨骼正确契合，使您能够恢复力量和活动范围。

在许多情况下，骨折涉及干骺端，即关节上方较宽的骨部分。如果该区域的骨骼碎裂，则称为粉碎性骨折。您的外科医生可能会使用骨移植替代物来填充空隙并提供结构稳定性。这些材料像脚手架一样，在您的身体愈合骨折时将破碎的骨块固定到位。此类骨折中骨骼不愈合（骨不连）的风险极小。

有时，骨折伴有尺骨茎突骨折，这是另一根前臂骨上的一个小骨性突起。您无需担心这个单独的骨折。伴随的尺骨茎突骨折不会影响您的桡骨远端骨折的预后。您的外科医生将专注于稳定桡骨，这是您康复的主要驱动因素。

并发症罕见，但必须预防。涉及正中神经和尺神经的神经损伤是一种极其罕见的并发症。早期诊断和治疗任何问题对于避免长期后果至关重要。您的外科医生将使用各种方法来固定骨骼，例如辅以经皮钢针的外固定。这种方法对于移位性骨折可产生可靠的良好结果，且并发症率低。关键在于早期识别和管理，以确保您恢复全部功能。

我们能做什么

您目前的首要任务是预防并发症。早期诊断和治疗对于避免长期后果至关重要。您应首先专注于自我管理和物理治疗。您的外科医生将指导您进行安全的活动。目标是在不造成进一步伤害的情况下恢复功能。软组织并发症可能比骨损伤本身更具挑战性。这些并发症包括肌腱损伤、神经功能障碍、皮肤问题以及复杂性区域疼痛综合征。您必须立即报告任何新出现的麻木或严重肿胀。合并正中神经和尺神经麻痹极为罕见，但如果发生，则需要标准化的管理策略。

医疗管理侧重于控制疼痛和炎症。您的外科医生可能会开具止痛药或抗炎药，以帮助您保持舒适。在某些情况下，可能会考虑注射治疗，如可的松、透明质酸或富血小板血浆（PRP），以减少肿胀和疼痛。这些治疗旨在为您的身体开始愈合提供缓解。这些注射的效果通常持续有限的时间，使您能够参与治疗。需要注意的是，骨移植替代物主要用于提供结构稳定性，而不仅仅是缓解疼痛。桡骨远端骨折的不愈合风险极小，因此重点仍在于软组织护理和对位。

当保守治疗达到极限时，会考虑手术治疗。如果存在明显的畸形或不稳定，您的外科医生可能会建议手术治疗。影像学因素，如干骺端塌陷比，有助于预测不稳定性。合并的尺骨茎突骨折不影响桡骨远端骨折的预后，因此临床医生在仅因此因素而选择手术治疗时应谨慎。外固定结合经皮钢针是移位骨折的极佳选择。该方法能产生可靠的良好结果，且再手术率和并发症率较低。与克氏针固定相比，掌侧钢板固定可能提供更优越的影像学结果，但这并不总是与32个月随访时的更好功能结果相关。最佳结果取决于对任何合并损伤（如腕骨内在韧带损伤）的早期识别和管理。如果不治疗，这些韧带损伤的延迟诊断将在10年内导致关节炎。

预期情况

您的外科医生的主要目标是预防并发症并确保您正确愈合。早期诊断和治疗对于避免长期问题至关重要。如果骨折得到妥善管理，大多数患者都能恢复良好。骨头不愈合（骨不连）的风险极小。

如果您接受钢板固定，您可能会发现腕骨的高度有轻微降低。这是正常现象，通常不会影响最终结果。如果您的手腕侧面（尺骨茎突）有小骨折，通常不会影响您的预后。您的外科医生会根据主要骨折情况来决定是否需要手术，而不仅仅是基于这一侧的骨折。

软组织损伤有时可能比骨折本身更成问题。这包括肌腱刺激、神经问题或皮肤问题。合并性神经损伤极为罕见。如果您有伴有脱位的复杂骨折，早期识别并保持骨头在正确位置是获得良好预后的关键。如果腕部韧带损伤未得到治疗，延迟诊断可能在10年内导致关节炎。

借助现代技术，您的外科医生可以恢复骨头的形状和稳定性。这有助于您更早恢复功能。对于移位性骨折，外固定架（使用钢针）是一个极好的选择，它能提供可靠的结果，且并发症和再次手术率较低。与克氏针相比，掌侧钢板在X光片上能提供更好的骨头对位，尽管在32个月时的功能预后相似。

如果置之不理或治疗不当，并发症可能会持续存在。您的外科医生会密切监测您，以便尽早发现任何问题。大多数患者能恢复腕部的良好功能。您应该预期在数周和数月内稳步改善。请遵循外科医生的建议，以保护愈合中的组织并避免挫折。

何时就诊

若疼痛持续且休息后无改善，或发现手腕无力或不稳，请咨询全科医生。若症状影响睡眠或工作，或出现突然加重，请要求专科医生评估。早期诊断和治疗对于避免长期后果至关重要。软组织并发症可能比骨损伤本身更为棘手。例如，若未及时治疗，腕内在韧带损伤的延迟诊断将在10年内导致关节炎。外科医生的主要关注点是通过早期识别和管理来预防这些问题。

Reviewed by AI synthesis (v2) — pending human review · 18 May 2026.

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Evidence & references

Overview

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
  • Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications [1].
  • Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
  • Combined median and ulnar nerve palsy complicating distal radius fractures require a standardised management strategy [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
  • Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
  • Novel locking plate designs have resulted in a rethinking of the contemporary approach to distal radius fracture fixation [6].
  • A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
  • Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
  • Bone graft substitutes may facilitate early return to function in distal radius fractures [9].
  • The risk of nonunion is minimal in distal radius fractures [9].
  • External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
  • External fixation supplemented with percutaneous pins yields reliably good results for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low reoperation rate for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low complication rate for displaced distal radius fractures [10].
  • Die punch fragment size is not an indicator of the need for or use of a dorsal approach in distal radius fracture fixation [17].

Anatomy & Pathophysiology

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern, with early diagnosis and treatment being important to avoid long-term consequences [1].
  • Combined median and ulnar nerve palsy related to distal fractures of the radius are exceedingly rare but require a standardized management strategy [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management, with restoration and maintenance of anatomic alignment being the key principles [4].
  • A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture and clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures, where the risk of nonunion is minimal [9].
  • Metaphyseal collapse ratio, a novel radiographic parameter, was found to provide a reliable measure of metaphyseal comminution, and to be significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
  • There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery [12].
  • Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes, while delayed diagnosis leads to arthritis within 10 years if not treated [16].
  • DP fragment size is not an indicator of the need for or use of a dorsal approach in distal radius fracture fixation [17].
  • Pronation effectively increases the proximal 'safe zone' of the posterior interosseous nerve, suggesting the forearm should be placed in pronation to minimize the risk of iatrogenic injury [18].
  • CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems [20].

Classification

  • CT scans do not significantly improve inter- and intra-observer agreement for the AO, Fernandez, and Universal classification systems for distal radius fractures [20].
  • The metaphyseal collapse ratio (MCR) is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
  • The metaphyseal collapse ratio (MCR) is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
  • There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery [12].

Clinical Presentation

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
  • Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications [1].
  • Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
  • Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
  • A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
  • Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures [9].
  • The risk of nonunion is minimal in distal radius fractures [9].
  • External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
  • External fixation supplemented with percutaneous pins yields reliably good results for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low reoperation rate for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low complication rate for displaced distal radius fractures [10].
  • Metaphyseal collapse ratio is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
  • Metaphyseal collapse ratio is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
  • There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery in distal radius fractures [12].
  • Soft tissue complications encountered during the management of distal radius fractures include tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome [15].
  • Complications associated with soft tissues may be more problematic than the bone injury itself in distal radius fractures [15].
  • Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes [16].
  • Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated [16].
  • Pronation effectively increases the proximal 'safe zone' of the posterior interosseous nerve [18].
  • The forearm should be placed in pronation to minimize the risk of iatrogenic injury to the posterior interosseous nerve [18].
  • Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken [19].
  • Pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention if not distinguished from Monteggia fractures [19].
  • Early recognition and treatment of Essex-Lopresti injury is associated with improved outcomes [21].

Investigations

  • Early diagnosis and treatment of complications associated with distal radius fractures are important to avoid long-term consequences [1].
  • Combined median and ulnar nerve palsy related to distal radius fractures is exceedingly rare [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
  • Restoration and maintenance of anatomic alignment are key principles in the treatment of forearm fracture–dislocations [4].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
  • Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Metaphyseal collapse ratio is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
  • Metaphyseal collapse ratio is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
  • There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery [12].
  • Soft tissue complications encountered during the management of distal radius fractures include tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome [15].
  • Complications associated with soft tissues may be more problematic than the bone injury itself in distal radius fractures [15].
  • Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes [16].
  • Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated [16].
  • Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken [19].
  • Pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention if misdiagnosed as Monteggia fractures [19].

Treatment

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
  • Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications [1].
  • Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
  • Combined median and ulnar nerve palsy complicating distal radius fractures require a standardised management strategy [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
  • Restoration and maintenance of anatomic alignment are key principles in the treatment of forearm fracture–dislocations [4].
  • A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
  • Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
  • Bone graft substitutes are used to perhaps provide early return to function in distal radius fractures [9].
  • The risk of nonunion is minimal in distal radius fractures [9].
  • External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures yields reliably good results [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low reoperation rate [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low complication rate [10].
  • There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery in distal radius fractures [12].
  • Superior radiological results were attained with volar plating compared to k-wiring for distal radius fractures [13].
  • Superior radiological results with volar plating did not correlate with a better functional outcome compared to k-wiring at 32 months follow up [13].

Complications

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
  • Early diagnosis and treatment of complications are important to avoid long-term consequences [1].
  • Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
  • Combined median and ulnar nerve palsy complicating distal radius fractures require a standardised management strategy [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
  • Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
  • A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
  • Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
  • Bone graft substitutes may provide early return to function in distal radius fractures [9].
  • The risk of nonunion in distal radius fractures is minimal [9].
  • External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures yields reliably good results [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low reoperation rate [10].
  • External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low complication rate [10].
  • Soft tissue complications encountered during the management of distal radius fractures include tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome [15].
  • Complications associated with soft tissues may be more problematic than the bone injury itself in distal radius fractures [15].

Recovery

  • Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
  • Early diagnosis and treatment of complications are important to avoid long-term consequences [1].
  • Combined median and ulnar nerve palsy related to distal radius fractures is exceedingly rare [2].
  • Combined median and ulnar nerve palsy complicating distal radius fractures requires a standardised management strategy [2].
  • Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
  • Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
  • A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
  • An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
  • Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
  • Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
  • Bone graft substitutes may facilitate early return to function in distal radius fractures [9].
  • The risk of nonunion in distal radius fractures is minimal [9].
  • External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
  • External fixation supplemented with percutaneous pins yields reliably good results for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low reoperation rate for displaced distal radius fractures [10].
  • External fixation supplemented with percutaneous pins has a low complication rate for displaced distal radius fractures [10].
  • Metaphyseal collapse ratio is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
  • Metaphyseal collapse ratio is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
  • Volar plating attains superior radiological results compared to k-wiring for distal radius fractures [13].
  • Superior radiological results with volar plating do not correlate with better functional outcomes compared to k-wiring at 32 months follow up [13].
  • Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes [16].
  • Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated [16].

Key Evidence

  • [Paper] Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern, with early diagnosis and treatment being important to avoid long-term consequences. [1] (10.1016/j.hcl.2014.12.002)
  • [Paper] Combined median and ulnar nerve palsy related to distal fractures of the radius are exceedingly rare but require a standardised management strategy. [2] (10.1016/j.otsr.2018.04.026)
  • [L5] Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management, with restoration and maintenance of anatomic alignment being the key principles. [4] (10.1016/j.hcl.2015.01.010)
  • [Paper] The management of distal radius fractures is in the midst of a renaissance with novel locking plate designs resulting in a rethinking of the contemporary approach to fracture fixation. [6] (10.1016/j.hcl.2005.04.001)
  • [Paper] A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures. [7] (10.1016/j.otsr.2021.102842)
  • [L1] Based on this meta-analysis, an associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture and clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture. [8] (10.1016/j.injury.2017.08.061)
  • [L4] Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures, where the risk of nonunion is minimal. [9] (10.1016/j.hcl.2012.02.004)
  • [L1] External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius, with reliably good results, a low reoperation rate, and a low complication rate. [10] (10.1016/j.hcl.2009.08.008)
  • [Paper] Metaphyseal collapse ratio, a novel radiographic parameter, was found to provide a reliable measure of metaphyseal comminution, and to be significantly correlated with other radiographic parameters that predict distal radius fracture instability. [11] (10.1016/j.otsr.2013.05.002)
  • [Paper] There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery. [12] (10.1007/s12593-014-0164-0)
  • [L3] Although superior radiological results were attained with volar plating, these results did not correlate with a better functional outcome compared to k-wiring at 32 months follow up. [13] (10.1016/j.injury.2015.08.040)
  • [L5] This review focuses on soft tissue complications encountered during the management of distal radius fractures, including tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome, noting that complications associated with soft tissues may be more problematic than the bone injury itself. [15] (10.1016/j.hcl.2009.11.002)
  • [L5] Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes, while delayed diagnosis leads to arthritis within 10 years if not treated. [16] (10.1016/j.hcl.2015.01.003)
  • [Paper] DP fragment size is not an indicator of the need for or use of a dorsal approach in DRF fixation. [17] (10.1055/s-0040-1712328)
  • [Paper] Pronation effectively increases the proximal 'safe zone' of the nerve, suggesting the forearm should be placed in pronation to minimize the risk of iatrogenic injury. [18] (10.1016/j.injury.2015.01.028)
  • [L4] Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken, and pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention. [19] (10.1016/j.injury.2005.08.028)
  • [Paper] CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems. [20] (10.1016/j.injury.2014.06.017)
  • [L5] Early recognition and treatment is associated with improved outcomes. [21] (10.1016/j.hcl.2020.07.012)

References

[1] Management of Complications of Distal Radius Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2014.12.002 [2] Combined median and ulnar nerve palsy complicating distal radius fractures. Orthopaedics & Traumatology: Surgery & Research. 2018. DOI: 10.1016/j.otsr.2018.04.026 [4] Management of Complications of Forearm Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.01.010 [6] Distal Radius Fractures. Hand Clinics. 2005. DOI: 10.1016/j.hcl.2005.04.001 [7] Loss of radial height in extra-articular distal radial fracture following volar locking plate fixation. Orthopaedics & Traumatology: Surgery & Research. 2021. DOI: 10.1016/j.otsr.2021.102842 [8] Does concomitant ulnar styloid fracture and distal radius fracture portend poorer outcomes? A meta-analysis of comparative studies. Injury. 2017. DOI: 10.1016/j.injury.2017.08.061 [9] The Use of Bone Grafts and Substitutes in the Treatment of Distal Radius Fractures. Hand Clinics. 2012. DOI: 10.1016/j.hcl.2012.02.004 [10] External Fixation of Distal Radius Fractures. Hand Clinics. 2010. DOI: 10.1016/j.hcl.2009.08.008 [11] Distal radius fracture metaphyseal comminution: A new radiographic parameter for quantifying, the metaphyseal collapse ratio (MCR). Orthopaedics & Traumatology: Surgery & Research. 2013. DOI: 10.1016/j.otsr.2013.05.002 [12] Radiographs Versus Radiographic Measurements in Distal Radius Fractures. Journal of Hand and Microsurgery. 2015. DOI: 10.1007/s12593-014-0164-0 [13] Volar plate versus k-wire fixation of distal radius fractures. Injury. 2016. DOI: 10.1016/j.injury.2015.08.040 [15] Soft Tissue Complications of Distal Radius Fractures. Hand Clinics. 2010. DOI: 10.1016/j.hcl.2009.11.002 [16] Management of Complications of Ligament Injuries of the Wrist. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.01.003 [17] The Die Punch Fragment: Analysis of Fragment Geometry and Need for Fixation. Journal of Hand and Microsurgery. 2022. DOI: 10.1055/s-0040-1712328 [18] The course of the posterior interosseous nerve in relation to the proximal radius: Is there a reliable landmark?. Injury. 2015. DOI: 10.1016/j.injury.2015.01.028 [19] When is a Monteggia fracture not a Monteggia fracture?. Injury Extra. 2007. DOI: 10.1016/j.injury.2005.08.028 [20] Does the CT improve inter- and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures?. Injury. 2014. DOI: 10.1016/j.injury.2014.06.017 [21] The Essex-Lopresti Injury:. Hand Clinics. 2020. DOI: 10.1016/j.hcl.2020.07.012

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