Management of complications of distal radius fractures

Abstract

Treating a fracture of the distal radius may require the surgeon to make a difficult decision between surgical treatment and nonsurgical management. The use of surgical fixation has recently increased because of complications associated with conservative treatment. However, conservative action may be necessary depending on certain patient factors. The treating surgeon must be aware of the possible complications associated with distal radius fracture treatments to prevent their occurrence. Prevention can be achieved with a proper understanding of the mechanism of these complications. This article discusses the most recent evidence on how to manage and prevent complications following a fracture of the distal radius.

Keywords: CRPS; Complications; Early diagnosis; Extensor tendon; Flexor tendon; Infection; Malunion; Preventive.

Copyright © 2015 Elsevier Inc. All rights reserved.

Figures

Figure 1

Patient diagnosed with complex regional pain syndrome presenting with a shiny appearance of the right hand.

Figure 2

a) Anteroposterior, b) Lateral and c) Oblique pre-operative x-rays of a patient who sustained a left intra-articular distal radius fracture. The fracture was fixated at an outside hospital; however, the articular surface collapsed causing DRUJ incongruity.

Figure 2

a) Anteroposterior, b) Lateral and c) Oblique pre-operative x-rays of a patient who sustained a left intra-articular distal radius fracture. The fracture was fixated at an outside hospital; however, the articular surface collapsed causing DRUJ incongruity.

Figure 2

a) Anteroposterior, b) Lateral and c) Oblique pre-operative x-rays of a patient who sustained a left intra-articular distal radius fracture. The fracture was fixated at an outside hospital; however, the articular surface collapsed causing DRUJ incongruity.

Figure 3

Patient presenting with purulent drainage from one of the dorsal pins, which resulted in pin removal.

Figure 4

Note the placement of the dorsal screws which do not penetrate the dorsal cortex, but rest 2mm under the dorsal cortex to prevent tendon injury. Also note the placement of the volar plate distally over the watershed line, which can cause irritation and possible rupture of the FPL.