Fractures of the distal radius are the commonest ones occurring usually in women after menopause when they put their hands on the ground trying to be protected while falling. The most serious fractures are those that extend into the radiocarpal joint.
They are treated predominantly conservatively with 4-5 weeks in plaster cast. In most cases reduction manoeuvres are required before immobilization. The surgeon strives for the best possible reduction because the quality of reduction is greatly associated with the outcome. Not anatomically reduced intrarticular fractures are prone to the development of post traumatic osteoarthritis.
When the fracture cannot be reduced adequately or is redisplaced while being in plaster cast or the fracture line is extended into the radioacarpal joint surgery is indicated. This is done under general anaesthesia, brachial block or Bier’s block. Various techniques and means are used involving special plates with screws, pins, external fixation.
Despite postoperative physiotherapy some stiffness of the wrist is usually expected.