Nonsurgical Treatment of a Distal Radius Fracture: When & How?
10.12671/jkfs.2018.31.2.71
- Author:
Young Ho SHIN
1
;
Jun O YOON
;
Jae Kwang KIM
Author Information
1. Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. orth4535@gmail.com
- Publication Type:Review
- Keywords:
Distal radius fracture;
Nonoperative treatment;
Dorsal til;
Radial shortening
- MeSH:
Aged;
Arm;
Congenital Abnormalities;
Exercise;
Fingers;
Hand;
Humans;
Joints;
Metacarpophalangeal Joint;
Radius Fractures;
Radius;
Range of Motion, Articular;
Splints;
Upper Extremity;
Wrist
- From:Journal of the Korean Fracture Society
2018;31(2):71-78
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Distal radius fractures are a common upper extremity fracture and a considerable number of patients have a stable fracture. In the treatment of distal radius fractures, there is considerable disagreement regarding the need for a strict anatomical restoration with operation in elderly patients. Therefore, nonsurgical treatment is a still important treatment option in distal radius fractures. The radiological parameters of before or after manual reduction are important for deciding whether to perform operation or not. The radiological parameters include dorsal angulation of the articular surface, radial shortening, extent of dorsal comminution, intra-articular displacement, concomitant ulnar metaphyseal fracture, shear fracture, and fracture-dislocation of the distal radio-ulnar joint. In addition, clinical situations of patients, including age, activity level, underline disease, and recovery level, which the patients wish should be considered, comprehensively. For the duration of a splint or cast, three to four weeks are recommended in impacted or minimally displaced fractures and five to six weeks in displaced fractures. After reduction of the displaced fractures, patients should undergo a radiologicical examination every week to check the redisplacement or deformity of the fracture site until two or three weeks post trauma. Arm elevation is important for controlling fracture site swelling and finger exercises, including metacarpophalangeal joint motion, are needed to prevent hand stiffness. Active range of motion exercise of the wrist should be initiated immediately after removing the splint or cast.
