1Lithuanian University of health science
Distal Radius fractures (DRF) are one of the most common injuries in the upper extremity. They make up about 3% of all upper extremity injuries. In the United States, DRF occurs at approximately 640,000 population per year , in Finland – 258 out of 100 thousand, in Great Britain – 36.8 cases of 10 thousand women and 9 cases of 10 thousand men over the age of 35, in the Netherlands – 26 cases of 10 thousand population per year [4, 5, 6, 7]. Incidence is expected to rise due to a growing elderly population. The complex decision to treat patients operatively or conservatively depends on a large variety of parameters which have to be considered. No unanimous consensus has been reached yet, which operative approach and fixation technique would produce the best postoperative functional results with lowest complication rates.
This article reviews the current evidence with respect to indications for surgery, surgical approaches, reduction and fixation techniques.
Methods: The PubMed, Embase, and Cochrane Library databases were searched for relevant studies published before 2015.
Conclusion: Indications of DRFs are dependent on many factors that influence the choice of surgical treatment. These include comorbidities, medication, functional and mental health. If surgery is necessary, then the majority of DRF can be stabilized by a palmar approach. Most of Orthopaedic centers prefers the Henry approach and the sheath of the FCR tendon should only be opened if access to the ulnar part of the radius is necessary. In the surgical standard setting, the aforementioned traction with Chinese finger traps has become an established method. Ideally, manual correction of the dislocation should be performed before the skin incision. A DRF can be reduced directly or indirectly, particularly with the aid of k-wires. Persistent instabilities may require either temporary transfixation of the carpus or a small special plate to achieve absolute stability.
Keywords: Distal radius fracture, Dorsal plating, Volar plating, Fixation technique.