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Surgical Techniques

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Fractures of the Distal Radius

Abstract

Reduction of fractures of the distal radius in most cases is obtained by applying the force opposite to that which produced the injury. Thus an understanding of the mechanism of injury proves useful when deciding on the appropriate reduction maneuvers. Dorsal bending-type fractures (Colles’) exhibit increased dorsal angulation, shortening, and radial deviation and supination of the distal fragment. Palmar bending fractures (Smith’s) have a reverse deformity pattern, with the distal fragment deviated in a palmar direction and variable degrees of shortening and pronation with reference to the ulna. Classically, dorsal bending fractures are reduced by applying longitudinal traction, palmar flexion, ulnar deviation, and pronation (Fig. 4.1). Restoration of skeletal length in displaced and impacted fractures may be readily obtained by increasing the initial deformity until one cortex engages the other. This contact point is then used as a fulcrum to realign the fragments with a flexion maneuver. The principle of reduction is based on applying tension on the soft tissue hinges located on the concavity of the angulation.

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Authors and Affiliations

  1. Orthopaedic Surgery, University of Bern, Bern

    Diego L. Fernandez M.D. (Professor and Staff Member)

  2. Orthopaedic Department, Lindenhof Hospital Bern, Mittelstr. 54, 3012, Bern, Switzerland

    Diego L. Fernandez M.D. (Professor and Staff Member)

  3. Orthopaedic Surgery Harvard Medical School, USA

    Jesse B. Jupiter M.D. (Professor and Director)

  4. Orthopaedic Hand Service, Massachusetts General Hospital, ACC 527, 15 Parkman Street, Boston, MA, 02114, USA

    Jesse B. Jupiter M.D. (Professor and Director)

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  1. Diego L. Fernandez M.D.
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Fernandez, D.L., Jupiter, J.B. (2002). Surgical Techniques. In: Fractures of the Distal Radius. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-0033-5_4

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