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Question
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“Hey Doc, do I knee surgery?”
Answer
Distal radius fractures are one of the most common orthopedic injuries
Usual mechanism is FOOSH
Treatment can be nonoperative or operative depending on multiple factors including fracture stability, displacement in addition to functional demands and age.
Non operative general indications include:
Extra-articular
< 5mm radial shortening
Dorsal angulation < 5° or <20° of contralateral distal radius
Factors where surgery is considered
Fractures assoc. w/ large ulnar styloid fractures (most or all) are at increased risk of DRUJ instability
Intra-articular displacement (step-off) particularly if greater than 2mm
Increased dorsal tilt/angulation (greater than 10° from neutral)
Radial shortening >3mm
In patients >65yo, dorsally displaced fractures can generally be primarily managed non-operatively unless there is significant deformity or neurological compromise.