Distal Radius Fractures

Communicate with anatomy, not only eponyms:

• Extra-articular vs partial articular vs complete articular
• Dorsal vs volar displacement / angulation
• Ulnar styloid and DRUJ involvement
• Osteopenia / metaphyseal void that predicts collapse

AO/OTA typing helps for research; on call, paint the picture the next surgeon needs.

After closed reduction and sugartong, ask:

• Are radial height, inclination, and volar tilt acceptable for this patient?
• Is the articular surface congruent?
• Will osteoporotic metaphysis hold, or is collapse inevitable?
• Is the DRUJ stable?

Young high-demand patients and intra-articular step-off push toward operative reconstruction. Fragile patients with acceptable alignment may do well non-op if followed closely.

• Closed reduction + sugartong / sugar-tong style immobilization for most acute presentations
• Re-image after reduction; document parameters
• Operative options: volar locking plate (common), fragment-specific fixation, external fixation / spanning constructs in select high-energy injuries
• Therapy and edema control matter as much as the implant for final function

• Know acceptable radiographic parameters and when they fail
• Articular step-off and unstable patterns drive ORIF discussion
• Median nerve symptoms after reduction need a clear plan
• DRUJ stability belongs in every presentation