7. • Most common orthopedic injury
• Most common mechanism : Falling On an Outstretched
Hand(FOOSH)
• Bimodal distribution
• younger patients - high energy
• older patients - low energy / falls
• 50% intra-articular
• Associated injuries : DRUJ, radial styloid fx (higher energy), soft tissue
injuries in (TFCC , scapholunate ligament, lunotriquetral ligament)
• Osteoporosis
• high incidence of distal radius fractures in women >50
• distal radius fractures are a predictor of subsequent fractures
• DEXA scan is recommended in woman with a distal radius fracture
Distal End Radius Fracture(DER)
11. INDICATION FOR SURGERY
1.Unstable
-type II,IV,V and some of type
I, III
-Lafontaine criteria >=3/5
-displacement after casting
3.Unacceptable
alignment
Radial inclination <15
Shortening>5mm
Dorsal tilt > 10
Articular step off /gap
>2mm
4. Open fx
2.Irreducible Fx
-Double die punch
-Displaced comminute
posteromedial fragment
-Articular step off > 2 mm
-Severe comminution
-Shortening > 5mm
17. • 3. short arm AP slab with 3 point molding
• 4.film wrist AP, lateral
• 5.F/U: 1-2 wk. ประเมินอาการบวม ,complication ,เปลี่ยนเป็น short arm
cast
: 6 wk. ถอดcast if no complication