Fixing a Distal Radius Fracture: Surgical Solutions for a Common Injury

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A distal radius fracture, often referred to as a wrist fracture, occurs near the end of the radius bone, close to the wrist. This type of fracture is common, especially among older adults and those who engage in high-impact activities. When the fracture is severe or displaced, surgical intervention may be required.

What is Distal Radius Fracture Fixation?

Surgical fixation of a distal radius fracture involves realigning the broken bone and securing it with hardware to ensure proper healing. There are several methods:

  1. Open Reduction and Internal Fixation (ORIF): This involves making an incision to directly access the fracture site. The bones are then realigned and held together with plates and screws.
  2. External Fixation: In cases where ORIF is not suitable, external fixation can be used. Pins are inserted into the bone above and below the fracture, and these are connected to an external frame that holds the bone in place.

Important Anatomic Structures

  • Radius: One of the two bones in the forearm, extending from the elbow to the wrist, and commonly fractured near the wrist.
  • Distal Radioulnar Joint (DRUJ): A joint at the wrist between the radius and ulna, important for forearm rotation.
  • Carpal Bones: The small bones forming the wrist joint, which articulate with the distal radius.
  • Tendons and Ligaments: Structures around the wrist that may be affected or injured in a distal radius fracture.

Steps in Performing Distal Radius Fracture Fixation

  1. Preoperative Preparation: The patient is positioned, and the affected arm is sterilized. A tourniquet is applied to control bleeding.
  2. Incision: For ORIF, an incision is made over the wrist to expose the fracture site. For external fixation, small incisions are made for pin insertion.
  3. Reduction: The fractured bone fragments are realigned to their normal anatomical position.
  4. Fixation: In ORIF, plates and screws are applied to secure the bone fragments. In external fixation, pins are inserted into the bone, and an external frame is attached.
  5. Closure: The incisions are closed with sutures, and a sterile dressing is applied.
  6. Postoperative Care: The patient is monitored in recovery, and instructions are provided for cast or splint care, as well as physical therapy.

Benefits of Surgical Fixation

  • Stable Alignment: Surgery ensures that the bones are properly aligned, which is crucial for optimal healing.
  • Enhanced Recovery: Proper fixation allows for earlier mobility and physical therapy, leading to better functional outcomes.
  • Reduced Complications: Surgical intervention reduces the risk of malunion or nonunion, where the bones heal improperly or not at all.

Recovery and Results

Post-surgery, patients may need to wear a cast or splint for a few weeks. Physical therapy is essential for regaining strength and flexibility. Full recovery can take several months, but most patients achieve excellent outcomes.

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