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From the American Academy of Orthopaedic Surgeons

Distal Radius Fracture (Colles' Fracture)

Intra-articular Distal Radius Fractures

by Christopher H. Allan, MD

Distal radius fractures are classified as intra-articular if the fracture line extends to or through the articular surface of either the radiocarpal or the distal radioulnar joints. Many distal radius fractures result from a fall on an outstretched hand. Management of intra-articular fractures is directed toward restoring the normal anatomy of the distal radius and ulna. Multiple studies have shown that the two parameters having the greatest influence on the outcome of distal radius fractures are ulnar variance and the adequacy of reduction of the articular surface.

The pathophysiology, etiology, and clinical presentation of distal radius fractures is reviewed, and considerations in management are presented. The nonsurgical management of articular fractures is extensively reviewed. Open reduction and internal fixation technique is presented, using volar and the dorsal approaches. Video is available.

Keywords: wrist fracture, wrist joint fracture, broken wrist, radiocarpal joint fracture, distal radioulnar joint fracture, DRUJ fracture, incidence, mechanism of injury, etiology, classification, diagnosis, patient history, physical examination, imaging, radiography, differential diagnosis, management, nonsurgical treatment, surgical treatment, surgical techniques, closed reduction, open reduction and internal fixation, surgical approaches, volar approach, dorsal approach, indications, contraindications, complications

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