Distal Radius Fractures: Let Me Show You What Trauma Surgeons Do! - - PowerPoint PPT Presentation

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Distal Radius Fractures: Let Me Show You What Trauma Surgeons Do! - - PowerPoint PPT Presentation

Oct 01, 2023 428 likes •948 views

Distal Radius Fractures: Let Me Show You What Trauma Surgeons Do! Lisa K. Cannada MD Disclosures No pertinent disclosures Member: AAOS Board of Directors MAOA Board of Directors OTA Committee Member Etiology Etiology

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Distal Radius Fractures: Let Me Show You What Trauma Surgeons Do!

Lisa K. Cannada MD

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Disclosures

  • No pertinent disclosures
  • Member:

– AAOS Board of Directors – MAOA Board of Directors – OTA Committee Member

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Etiology

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Etiology

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Etiology

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Who Did This?

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Trauma or Hand

26%

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Trauma or Hand

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Trauma or Hand

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Trauma or Hand

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Trauma or Hand

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Trauma or Hand

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Treatment Goals & Considerations

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Factors to Consider

  • Age
  • Dominance
  • Demand
  • Additional Injuries
  • Medical co-morbidities
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What Does This Mean?

4685

11/22/17

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Treatment Options

  • Nonoperative
  • Percutaneous pinning
  • External fixation
  • ORIF
  • Combination
  • Adjuncts
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Before You Start

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Treatment

  • Kwire fixation

–Acceptable CR –Give subchondral support –May unload joint with Ex Fix

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External Fixation

  • Don’t throw away the ex fix!
  • Fractures with metaphyseal

comminution

  • Open fractures
  • Polytrauma patient
  • In combination with other treatments
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Pin Placement Proximally: Open incision

Identify SRN

Between ECRL and ECRB

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Ex Fix

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Ex Fix

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Case Example

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“Regular” Plating

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“Regular” Plating

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Know Your Plate

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Volar Approach

  • Identify

landmarks

  • Find FCR
  • Can extend into

carpal tunnel if necessary

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Volar Approach

  • Incise FCR

volar sheath

  • Identify radial

artery

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Volar Approach

  • Retract FCR

ulnarly

  • Then incise FCR

dorsal sheath

  • Pronator

quadratus identified

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Volar Approach

  • Incise pronator

quadratus

  • Avoid radiocarpal

joint arthrotomy Tip: Can release brachioradialis for styloid exposure

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Volar Approach

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Getting the reduction…

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Reduce & Hold Before Plating…

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Radiographic Evaluation

  • Pronated

Oblique View

  • Dorsal

Tangential View

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Dorsal Plating

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Always Evaluate the DRUJ

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Always be prepared…

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Surprise!!!

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Trauma or Hand

20%

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Trauma or Hand

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Trauma or Hand

59% , 23%

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Trauma or Hand

59%

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Summary

  • There is no gold

standard for treatment or fixation

  • Maintain many

“tools” in your armamentarium

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Thank You!

Lcannada@slu.edu