[Distal radius fracture-tactic and approach]. / Distale Radiusfrakturen Taktik und Zugangswahl.
Oper Orthop Traumatol
; 35(6): 352-369, 2023 Dec.
Article
en De
| MEDLINE
| ID: mdl-37395767
OBJECTIVE: The aim of surgical treatment is fracture healing with restored alignment, rotation, and joint surface. Stable fixation allows for functional postoperative aftercare. INDICATIONS: Displaced intra- and extra-articular fractures which either could not be adequately reduced or in which a secondary displacement is to expected due to instability criteria. The following factors are considered instability criteria: age >â¯60 years, female, initial dorsal displacement >â¯20°, dorsal comminution, radial shortening >â¯5â¯mm, palmar displacement. CONTRAINDICATIONS: The only absolute contraindication is if the patient is deemed unfit for surgery due to concerns regarding anesthesia. Old age is a relative contraindication, as it is currently debated whether older patients benefit from the operation. SURGICAL TECHNIQUE: The surgical technique is guided by the fracture pattern. Palmar plating is most commonly performed. If the joint surface needs to be visualized, a dorsal approach (in combination with another approach or alone) or arthroscopically assisted fixation should be chosen. POSTOPERATIVE MANAGEMENT: In general, a functional postoperative regime can be carried out after plate fixation with mobilization without weightbearing. Short-term splinting can provide pain relief. Concomitant ligamentous injuries and fixations, which are not stable enough for functional aftercare (such as kwires) require a longer period of immobilization. RESULTS: Provided the fracture is reduced correctly, osteosynthesis improves functional outcome. The complication rate ranges between 9 and 15% with the most common complication being tendon irritation/rupture and plate removal. Whether surgical treatment holds the same benefits for patients >â¯65 years as for younger patients is currently under debate.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fracturas del Radio
/
Traumatismos de los Tendones
/
Traumatismos de la Muñeca
/
Fracturas de la Muñeca
Límite:
Female
/
Humans
/
Middle aged
Idioma:
De
Revista:
Oper Orthop Traumatol
Asunto de la revista:
ORTOPEDIA
/
TRAUMATOLOGIA
Año:
2023
Tipo del documento:
Article
Pais de publicación:
Alemania