Treatment of Explosion-Type Distal Radius Fractures

  • Francisco del PiñalEmail author


We have defined explosion-type distal radius fracture (DRF) as any fracture with more than four articular fragments, or in any case where there was a single, free (central) osteochondral fragment (Fig. 4.1). This group is more difficult to approach from an arthroscopy point of view, and has been considered as the “last frontier” [13, 14, 21, 28]. By the same token, in our opinion, it is the one that benefits the most from improving its dim prognosis as arthroscopy may allow to achieve anatomic reduction of the articular surface.


Carpal Tunnel Syndrome Carpal Tunnel Distal Radius Fracture Flexor Tendon Flexor Carpus Radialis 
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  1. 1.
    Adolfsson L, Jörgsholm P. Arthroscopically-assisted reduction of intra-articular fractures of the distal radius. J Hand Surg. 1998;23B:391–5Google Scholar
  2. 2.
    Andermahr J, Lozano-Calderon S, Trafton T, Crisco JJ, Ring D. The volar extension of the lunate facet of the distal radius: a quantitative anatomic study. J Hand Surg. 2006;31A: 892–5Google Scholar
  3. 3.
    Apergis E, Darmanis S, Theodoratos G, Maris J. Beware of the ulno-palmar distal radial fragment. J Hand Surg. 2002;27B:139–45Google Scholar
  4. 4.
    Chin KR, Jupiter JB. Wire-loop fixation of volar displaced osteochondral fractures of the distal radius. J Hand Surg. 1999;24A:525–33Google Scholar
  5. 5.
    del Piñal F. Dry arthroscopy of the wrist: Its role in the management of articular distal radius fractures. Scand J Surg. 2008;97:298–304PubMedGoogle Scholar
  6. 6.
    del Piñal F, García-Bernal FJ, Delgado J, Sanmartín M, Regalado J, Cerezal L. Correction of malunited intra-articular distal radius fractures with an inside-out osteotomy technique. J Hand Surg. 2006;31A:1029–234Google Scholar
  7. 7.
    del Piñal F, García-Bernal FJ, Pisani D, Regalado J, Ayala H, Studer A. Dry arthroscopy of the wrist: surgical technique. J Hand Surg. 2007;32A:119–23Google Scholar
  8. 8.
    del Piñal F, Studer A, García Bernal FJ, Regalado J, Cagigal L, Thams C. Explosion type articular distal radius fractures: technique and results of volar locking plate under dry arthroscopic guidance. FESSH Congress. Poznan, Poland. 2009Google Scholar
  9. 9.
    Doi K, Hattori Y, Otsuka K, Abe Y, Yamamoto H. Intra-articular fractures of the distal aspect of the radius: arthroscopically assisted reduction compared with open reduction and internal fixation. J Bone Joint Surg. 1999;81A: 1093–110Google Scholar
  10. 10.
    Dumontier C, Meyer zu Reckendorf G, Sautet A, Lenoble E, Saffar P, Allieu Y. Radiocarpal dislocations: classification and proposal for treatment. A review of twenty-seven cases. J Bone Joint Surg. 2001;83A:212–18Google Scholar
  11. 11.
    Fernandez DL, Geissler WB. Treatment of displaced articular fractures of the radius. J Hand Surg. 1991;16A:375–84Google Scholar
  12. 12.
    Fernandez DL, Jupiter JB. Surgical techniques. In: Fractures of the distal radius. A practical approach to management. 2nd ed. New York: Springer; 2002. p. 71–127Google Scholar
  13. 13.
    Geissler WB. Intra-articular distal radius fractures: the role of arthroscopy? Hand Clin. 2005;21:407–16CrossRefPubMedGoogle Scholar
  14. 14.
    Guofen C, Doi K, Hattori Y, Kitajima I. Arthroscopically assisted reduction and immobilization of intraarticular fracture of the distal end of the radius: several options of reduction and immobilization. Tech Hand Up Extrem Surg. 2005;9:84–90Google Scholar
  15. 15.
    Harness NG, Jupiter JB, Orbay JL, Raskin KB, Fernandez DL. Loss of fixation of the volar lunate facet fragment in fractures of the distal part of the radius. J Bone Joint Surg. 2004;86A:1900–8Google Scholar
  16. 16.
    Jupiter JB, Fernandez DL, Toh CL, Fellman T, Ring D. Operative treatment of volar intra-articular fractures of the distal end of the radius. J Bone Joint Surg. 1996;78A: 1817–28Google Scholar
  17. 17.
    Lozano-Calderón SA, Doornberg J, Ring D. Fractures of the dorsal articular margin of the distal part of the radius with dorsal radiocarpal subluxation. J Bone Joint Surg. 2006; 88A:1486–93CrossRefGoogle Scholar
  18. 18.
    Marx RG, Axelrod TS. Intraarticular osteotomy of distal radius malunions. Clin Orthop. 1996;327:152–7CrossRefPubMedGoogle Scholar
  19. 19.
    Mathoulin C, Haerle M. Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion. J Hand Surg. 1998;23B:318–23Google Scholar
  20. 20.
    Medoff RJ. Essential radiographic evaluation for distal radius fractures. Hand Clin. 2005;21:279–88Google Scholar
  21. 21.
    Mehta JA, Bain GI, Heptinstall RJ. Anatomical reduction of intra-articular fractures of the distal radius. An arthroscopically-assisted approach. J Bone Joint Surg. 2000;82B: 79–86CrossRefGoogle Scholar
  22. 22.
    Melone CP Jr. Distal radius fractures: patterns of articular fragmentation. Orthop Clin North Am. 1993;24:239–53PubMedGoogle Scholar
  23. 23.
    Müller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures of long bones. New York: Springer; 1990Google Scholar
  24. 24.
    Ring D, Prommersberger K, Jupiter JB. Combined dorsal and volar plate fixation of complex fractures of the distal part of the radius. J Bone Joint Surg. 2004;86-A:1646–52Google Scholar
  25. 25.
    Rogachefsky RA, Lipson SR, Applegate B, Ouellette EA, Savenor AM, McAuliffe JA. Treatment of severely comminuted intra-articular fractures of the distal end of the radius by open reduction and combined internal and external fixation. J Bone Joint Surg. 2001;83A:509–19Google Scholar
  26. 26.
    Slutsky DJ. Clinical applications of volar portals in wrist arthroscopy. Tech Hand Up Extrem Surg. 2004;8:229–38Google Scholar
  27. 27.
    Thomas AD, Greenberg JA. Use of fluoroscopy in determining screw overshoot in the dorsal distal radius: a cadaveric study. J Hand Surg. 2009;34A:258–61Google Scholar
  28. 28.
    Wiesler ER, Chloros GD, Mahirogullari M, Kuzma GR. Arthroscopic management of distal radius fractures. J Hand Surg. 2006;31A:1516–26Google Scholar

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© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Head of Hand and Plastic SurgeryPrivate practice Hospital Mutua MontañesaSantanderSpain

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