Conservative treatment of distal radial fractures

Oper Orthop Traumatol. 2023 Jul 5. doi: 10.1007/s00064-023-00820-y. Online ahead of print.ABSTRACTOBJECTIVE: Distal fracture of the radius is common in all age groups. Under careful consideration of individual indications and contraindications, conservative treatment with reduction and immobilization can have significant advantages over the frequently applied surgical approach, particularly in older patients.THERAPEUTIC GOAL: Immobilization after closed reduction enables satisfactory wrist function to be achieved according to individual patient expectations.INDICATIONS: A. Patients with a. significant comorbidities, b. high surgical risk from an anesthesiology perspective (ASA > 3), c. low functional requirements, d. low cosmetic expectations regarding residual visible deformity. B. Young patients with an extension fracture and additional a. < 10° dorsal tilt in the case of extraarticular fractures after closed reduction, b. < 5 mm radial shortening after closed reduction, c. < 2 mm intraarticular displacement after closed reduction.CONTRAINDICATIONS: A. Patient age < 65 years with an extension fracture and additional a. > 10° dorsal tilt in the case of extraarticular fractures after closed reduction, b. > 5 mm radial shortening after closed reduction, c. > 2 mm intraarticular displacement after closed reduction. B. Flexion fracture for which ligamentotaxis for closed reduction is not possible. C. Open distal radial fracture. D. Fracture dislocations...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Source Type: research