Fractures of the Distal Radius

Abstract

Fractures of the distal radius are the most common fractures in the upper limb of the middleand older-age population. These fractures, commonly classified as Colles’ fractures, have received relatively little attention in orthopaedic circles. Perhaps this is due to the fact that none of the commonly used methods of treatment have been able to completely eliminate the complications of shortening and loss of the radial and volar tilt of the distal radius. Such complications have been accepted as inevitable in certain fractures and their clinical significance have not been considered serious. Patients seem to get accustomed to the deformity and the residual limitation of motion and weakness of grasp. All common methods of treatment seem to require a relatively long period of incapacitation before maximum recovery is achieved. Some have recommended methods of treatment which ensure maintenance of reduction of the fragments either by internal fixation of the fragments or by external fixators with pins above and below the fracture. This latter treatment, although capable of providing maintenance of anatomic reduction, is often associated with complications of varying types, such as loosening of the pins and low grade infections along their tracts. More important perhaps is the fact that the rigid immobilization of the wrist joint in a distracted position leads to the development of stiffness which in the elderly requires a long time before its complete disappearance.