Open reduction and internal fixation of the distal radius
Fractures of the distal radius are one of the most common problems treated by orthopaedic surgeons. The management of unstable fractures is now almost routinely surgical, and multiple techniques have been developed to accomplish this including pins and plaster, external fixation, and internal fixation. Recent studies and classification systems have stressed the importance of identification of specific fracture fragments. Given that the goal of operative management of the fracture is an anatomic reduction and stable fixation, open reduction and internal fixation has been utilized recently to a greater degree. This allows direct reduction of the fracture with a stable construct. Advantages over external fixation or pins and plaster include a more anatomic reduction, establishment of early range of motion, and avoidance of complications associated with external pins. A dorsal or volar approach can be employed depending on fracture pattern and associated bony or soft tissue injuries. A variety of plating systems are now available, many of which are contoured specifically for the distal radius. Results of open reduction and internal fixation for distal radius fractures have generally shown greater than 80% good results. Complications can also occur including tenosynovitis, tendon rupture, and carnal tunnel syndrome. © 2003 Elsevier Inc. All rights reserved.
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