Distal Radius Fractures

Description

In this segment, Dr. Matthew Costa discusses the assessment and management of dorsally displaced distal radius fractures, emphasizing the importance of evaluating the need for manipulation based on the fracture's alignment and patient comfort. He outlines a preferred protocol involving splinting for well-aligned fractures, referencing the ongoing DRAFFT 3 trial that examines treatment approaches for these injuries.



Dr. Costa notes that if a manipulation is necessary, it typically occurs in the fracture clinic's plaster room under controlled conditions, allowing for a molded cast to be applied post-reduction. The DRAFFT 2 trial is cited, which indicates that many patients achieve successful outcomes with molded casts after closed reduction.



He elaborates on the procedures followed when closed reduction isn't achievable, explaining that such cases often require an operating theater intervention for open reduction, using plates and screws primarily for complex intra-articular fractures. This protocol aims to reduce surgical interventions and effectively manage resources, resulting in fewer patients requiring surgery and optimal use of surgical materials. Overall, Dr. Costa advocates for a judicious approach to using hardware in fracture management, ensuring it's employed only when necessary based on specific fracture characteristics.

DOI: 10.1302/3114-251098

Specialties