Distal Radius Fracture Info Evidence
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
What you're feeling
You will likely feel sharp pain in your wrist and forearm right after the injury. The pain often stays there for a while. It may hurt more when you try to move your hand or wrist. Simple tasks can become difficult. You might struggle to reach behind your back to fasten a bra. Tucking in a shirt can also be painful. Lifting even light objects may feel impossible at first.
Swelling and bruising are common. Your wrist may look swollen or discolored. The pain can flare up at night, making it hard to sleep. You might find it uncomfortable to lie on the affected side. Waking up with a stiff, painful wrist is typical in the early days. This discomfort usually gets better with rest and elevation.
Numbness or tingling in your fingers can happen. This is due to nerve irritation from the swelling or the fracture itself. Combined nerve issues in both the median and ulnar nerves are exceedingly rare. If you feel persistent numbness, tell your surgeon. Early diagnosis of any nerve or ligament issues helps prevent long-term problems. Delayed treatment of these soft tissue injuries can lead to arthritis within 10 years if not treated.
Some people feel a grinding sensation when they try to move their wrist. This is because the broken bone ends are rubbing together. Your surgeon will check for any associated injuries, such as those to the carpal ligaments in your wrist. These soft tissue complications can be more problematic than the bone injury itself. Early accurate diagnosis provides the best outcomes for your recovery.
Pain management is a key part of your care. Your surgeon will guide you on how to manage this discomfort. Prevention of complications should be the primary concern during your treatment. Early diagnosis and treatment are important to avoid long-term consequences. You may need to keep your wrist still to let the bone heal. This rest helps reduce pain and prevents further damage.
What's actually happening
When you break the end of your forearm bone, the smooth surface that lets your wrist twist and bend can become uneven. Think of this surface like a gasket in a car engine. If it is cracked or misaligned, the joint does not seal or move smoothly. This causes pain and stiffness when you try to turn your hand.
The break often happens in the spongy part of the bone near the joint. This area can crush or collapse under pressure. Your surgeon looks at X-rays to see how much the bone has shifted. The goal is to put the bone pieces back in their original shape. This is called restoring anatomic alignment. Getting this alignment right is key to a good outcome. If the bone heals in the wrong position, your wrist may not work as well as it should.
Sometimes, the break involves a small piece of bone that pushes into the joint. This is known as a die punch fragment. The size of this piece does not decide if you need surgery or which side of the wrist we operate from. We look at other signs to decide the best path. You might also have a small break in the ulnar bone on your pinky side. This associated fracture does not change how your main wrist fracture heals. We do not need to treat it separately in most cases.
Nerve damage is a serious concern, but combined nerve palsy is exceedingly rare. This means it is very uncommon for both major nerves in your wrist to be injured at the same time. Your surgeon prioritizes preventing complications. Early diagnosis and treatment help avoid long-term issues. We use modern techniques, like locking plates or external frames with pins, to hold the bone steady. These methods provide stability while the bone heals. The risk of the bone failing to heal is minimal. This allows you to start moving your hand sooner and return to function faster.
What we can do about it
How Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, approaches this in our clinic reflects a clear path for your recovery. Patients reach our clinic by GP or physiotherapist referral. A clinic assessment (history, examination, and imaging where needed) establishes the diagnosis. For structural or acute problems, surgery may be recommended straight away. For degenerative or long-standing problems, we usually try non-operative care first.
You can start with self-management and physiotherapy. Rest the wrist and use ice to reduce swelling. Your physiotherapist will guide you through gentle movements to keep the joint flexible. This approach aims to restore normal motion and strength without invasive steps. We typically give this conservative care a set period to work before considering other options. Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications.
If pain persists, we discuss medical management. This may include pain medication or anti-inflammatories to control discomfort. In some cases, we consider injections. Cortisone injections reduce inflammation and pain for a limited time. Hyaluronic acid injections may help lubricate the joint, though evidence for their long-term benefit varies. Platelet-rich plasma (PRP) injections use your own blood components to support healing, but results can differ between patients. We choose these options based on your specific symptoms and how your body responds.
Surgery is considered when conservative care has not given enough improvement or if the bone is significantly displaced. Our goal is to restore and maintain anatomic alignment to ensure proper function. We use techniques such as external fixation supplemented with percutaneous pins for displaced fractures. This method yields reliably good results with a low complication rate. We also use volar locking plates for extra-articular fractures, noting that some patients may experience a certain degree of radial height loss. An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture, so we do not let it change our primary plan. We aim for optimal outcomes through early recognition and management of any associated injuries, such as soft tissue complications or intrinsic carpal ligament injuries. Delayed diagnosis of these issues can lead to arthritis within 10 years if not treated. We present these options as a shared decision, ensuring you understand the risks and benefits of each path.
What to expect
Your primary concern right now is likely pain and stability. Your surgeon’s main goal is to prevent complications from the start. Early diagnosis and treatment are important to avoid long-term consequences. Most people settle into a steady recovery path when managed well. The risk of the bone failing to heal (nonunion) is minimal.
You may notice some changes in the shape of your wrist. A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures. This is a normal part of the healing process for many. An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture. You do not need to worry if this small bone fragment is also broken.
Soft tissue issues can sometimes be more problematic than the bone injury itself. These include tendon injury, nerve dysfunction, or skin problems. Combined median and ulnar nerve palsy related to distal radius fractures is exceedingly rare. If you have wrist stiffness, early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes. Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated.
Recovery feels different depending on your fracture type. For displaced fractures, external fixation supplemented with percutaneous pins yields reliably good results. This method has a low reoperation rate and a low complication rate. Volar plating attains superior radiological results compared to k-wiring for distal radius fractures. However, superior radiological results with volar plating do not correlate with a better functional outcome compared to k-wiring at 32 months follow up.
If left alone, symptoms may persist or lead to joint wear. Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management. Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations. Bone graft substitutes are primarily used to provide structural stability in distal radius fractures. They are used to perhaps enable early return to function in distal radius fractures.
Your outlook is generally positive with proper care. You can expect to regain function over weeks to months. Stay close to your follow-up appointments. This allows your surgeon to catch any soft tissue issues early. Your patience during the healing phase is key to a good result.
When to see someone
See your GP if you have persistent pain that does not improve with rest. Ask for a specialist review if you notice weakness or instability in your wrist. Seek urgent care if your hand locks or gives way. Contact your doctor if symptoms interfere with your sleep or work. Sudden worsening of pain or swelling requires prompt attention. Early diagnosis helps avoid long-term consequences. Soft tissue complications can be more problematic than the bone injury itself. Timely management of nerve dysfunction or tendon injury leads to better outcomes. Do not ignore signs of vascular compromise or skin problems. Early recognition of associated injuries, such as carpal ligament tears, prevents future arthritis.
Evidence & references
Overview
- Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
- Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications [1].
- Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
- Combined median and ulnar nerve palsy complicating distal radius fractures require a standardised management strategy [2].
- Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
- Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
- Novel locking plate designs have resulted in a rethinking of the contemporary approach to distal radius fracture fixation [6].
- A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
- An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
- Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
- Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
- Bone graft substitutes may facilitate early return to function in distal radius fractures [9].
- The risk of nonunion is minimal in distal radius fractures [9].
- External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
- External fixation supplemented with percutaneous pins yields reliably good results for displaced distal radius fractures [10].
- External fixation supplemented with percutaneous pins has a low reoperation rate for displaced distal radius fractures [10].
- External fixation supplemented with percutaneous pins has a low complication rate for displaced distal radius fractures [10].
- Die punch fragment size is not an indicator of the need for or use of a dorsal approach in distal radius fracture fixation [17].
Anatomy & Pathophysiology
- Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern, with early diagnosis and treatment being important to avoid long-term consequences [1].
- Combined median and ulnar nerve palsy related to distal fractures of the radius are exceedingly rare but require a standardized management strategy [2].
- Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management, with restoration and maintenance of anatomic alignment being the key principles [4].
- A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
- An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture and clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
- Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures, where the risk of nonunion is minimal [9].
- Metaphyseal collapse ratio, a novel radiographic parameter, was found to provide a reliable measure of metaphyseal comminution, and to be significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
- There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery [12].
- Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes, while delayed diagnosis leads to arthritis within 10 years if not treated [16].
- DP fragment size is not an indicator of the need for or use of a dorsal approach in distal radius fracture fixation [17].
- Pronation effectively increases the proximal 'safe zone' of the posterior interosseous nerve, suggesting the forearm should be placed in pronation to minimize the risk of iatrogenic injury [18].
- CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems [20].
Classification
- CT scans do not significantly improve inter- and intra-observer agreement for the AO, Fernandez, and Universal classification systems for distal radius fractures [20].
- The metaphyseal collapse ratio (MCR) is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
- The metaphyseal collapse ratio (MCR) is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
- There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery [12].
Clinical Presentation
- Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
- Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications [1].
- Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
- Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
- Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
- A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
- An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
- Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
- Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures [9].
- The risk of nonunion is minimal in distal radius fractures [9].
- External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
- External fixation supplemented with percutaneous pins yields reliably good results for displaced distal radius fractures [10].
- External fixation supplemented with percutaneous pins has a low reoperation rate for displaced distal radius fractures [10].
- External fixation supplemented with percutaneous pins has a low complication rate for displaced distal radius fractures [10].
- Metaphyseal collapse ratio is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
- Metaphyseal collapse ratio is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
- There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery in distal radius fractures [12].
- Soft tissue complications encountered during the management of distal radius fractures include tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome [15].
- Complications associated with soft tissues may be more problematic than the bone injury itself in distal radius fractures [15].
- Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes [16].
- Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated [16].
- Pronation effectively increases the proximal 'safe zone' of the posterior interosseous nerve [18].
- The forearm should be placed in pronation to minimize the risk of iatrogenic injury to the posterior interosseous nerve [18].
- Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken [19].
- Pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention if not distinguished from Monteggia fractures [19].
- Early recognition and treatment of Essex-Lopresti injury is associated with improved outcomes [21].
Investigations
- Early diagnosis and treatment of complications associated with distal radius fractures are important to avoid long-term consequences [1].
- Combined median and ulnar nerve palsy related to distal radius fractures is exceedingly rare [2].
- Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
- Restoration and maintenance of anatomic alignment are key principles in the treatment of forearm fracture–dislocations [4].
- An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
- Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
- Metaphyseal collapse ratio is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
- Metaphyseal collapse ratio is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
- There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery [12].
- Soft tissue complications encountered during the management of distal radius fractures include tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome [15].
- Complications associated with soft tissues may be more problematic than the bone injury itself in distal radius fractures [15].
- Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes [16].
- Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated [16].
- Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken [19].
- Pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention if misdiagnosed as Monteggia fractures [19].
Treatment
- Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
- Early diagnosis and treatment are important to avoid long-term consequences of distal radius fracture complications [1].
- Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
- Combined median and ulnar nerve palsy complicating distal radius fractures require a standardised management strategy [2].
- Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
- Restoration and maintenance of anatomic alignment are key principles in the treatment of forearm fracture–dislocations [4].
- A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
- An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
- Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
- Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
- Bone graft substitutes are used to perhaps provide early return to function in distal radius fractures [9].
- The risk of nonunion is minimal in distal radius fractures [9].
- External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
- External fixation supplemented with percutaneous pins for displaced distal radius fractures yields reliably good results [10].
- External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low reoperation rate [10].
- External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low complication rate [10].
- There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery in distal radius fractures [12].
- Superior radiological results were attained with volar plating compared to k-wiring for distal radius fractures [13].
- Superior radiological results with volar plating did not correlate with a better functional outcome compared to k-wiring at 32 months follow up [13].
Complications
- Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
- Early diagnosis and treatment of complications are important to avoid long-term consequences [1].
- Combined median and ulnar nerve palsy related to distal fractures of the radius is exceedingly rare [2].
- Combined median and ulnar nerve palsy complicating distal radius fractures require a standardised management strategy [2].
- Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
- Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
- A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
- An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
- Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
- Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
- Bone graft substitutes may provide early return to function in distal radius fractures [9].
- The risk of nonunion in distal radius fractures is minimal [9].
- External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
- External fixation supplemented with percutaneous pins for displaced distal radius fractures yields reliably good results [10].
- External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low reoperation rate [10].
- External fixation supplemented with percutaneous pins for displaced distal radius fractures has a low complication rate [10].
- Soft tissue complications encountered during the management of distal radius fractures include tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome [15].
- Complications associated with soft tissues may be more problematic than the bone injury itself in distal radius fractures [15].
Recovery
- Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern [1].
- Early diagnosis and treatment of complications are important to avoid long-term consequences [1].
- Combined median and ulnar nerve palsy related to distal radius fractures is exceedingly rare [2].
- Combined median and ulnar nerve palsy complicating distal radius fractures requires a standardised management strategy [2].
- Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management [4].
- Restoration and maintenance of anatomic alignment are key principles for optimal outcomes in forearm fracture–dislocations [4].
- A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures [7].
- An associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture [8].
- Clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture [8].
- Bone graft substitutes are primarily used to provide structural stability in distal radius fractures [9].
- Bone graft substitutes may facilitate early return to function in distal radius fractures [9].
- The risk of nonunion in distal radius fractures is minimal [9].
- External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius [10].
- External fixation supplemented with percutaneous pins yields reliably good results for displaced distal radius fractures [10].
- External fixation supplemented with percutaneous pins has a low reoperation rate for displaced distal radius fractures [10].
- External fixation supplemented with percutaneous pins has a low complication rate for displaced distal radius fractures [10].
- Metaphyseal collapse ratio is a novel radiographic parameter that provides a reliable measure of metaphyseal comminution [11].
- Metaphyseal collapse ratio is significantly correlated with other radiographic parameters that predict distal radius fracture instability [11].
- Volar plating attains superior radiological results compared to k-wiring for distal radius fractures [13].
- Superior radiological results with volar plating do not correlate with better functional outcomes compared to k-wiring at 32 months follow up [13].
- Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes [16].
- Delayed diagnosis of intrinsic carpal ligament injuries leads to arthritis within 10 years if not treated [16].
Key Evidence
- [Paper] Prevention of complications associated with distal radius fractures should be the treating surgeon's primary concern, with early diagnosis and treatment being important to avoid long-term consequences. [1] (10.1016/j.hcl.2014.12.002)
- [Paper] Combined median and ulnar nerve palsy related to distal fractures of the radius are exceedingly rare but require a standardised management strategy. [2] (10.1016/j.otsr.2018.04.026)
- [L5] Optimal outcomes in the treatment of forearm fracture–dislocations depend on early recognition and management, with restoration and maintenance of anatomic alignment being the key principles. [4] (10.1016/j.hcl.2015.01.010)
- [Paper] The management of distal radius fractures is in the midst of a renaissance with novel locking plate designs resulting in a rethinking of the contemporary approach to fracture fixation. [6] (10.1016/j.hcl.2005.04.001)
- [Paper] A certain degree of radial height loss is noted in patients undergoing fracture fixation with volar locking plate for extra-articular distal radius fractures. [7] (10.1016/j.otsr.2021.102842)
- [L1] Based on this meta-analysis, an associated ulnar styloid fracture does not affect the outcomes of a distal radial fracture and clinicians should be cautious in electing operative treatment for patients with an ulnar styloid fracture. [8] (10.1016/j.injury.2017.08.061)
- [L4] Bone graft substitutes are primarily used to provide structural stability and perhaps early return to function in distal radius fractures, where the risk of nonunion is minimal. [9] (10.1016/j.hcl.2012.02.004)
- [L1] External fixation supplemented with percutaneous pins is an excellent option for treating displaced fractures of the distal radius, with reliably good results, a low reoperation rate, and a low complication rate. [10] (10.1016/j.hcl.2009.08.008)
- [Paper] Metaphyseal collapse ratio, a novel radiographic parameter, was found to provide a reliable measure of metaphyseal comminution, and to be significantly correlated with other radiographic parameters that predict distal radius fracture instability. [11] (10.1016/j.otsr.2013.05.002)
- [Paper] There may be radiographic factors other than measures of deformity that some surgeons use to determine recommendations for surgery. [12] (10.1007/s12593-014-0164-0)
- [L3] Although superior radiological results were attained with volar plating, these results did not correlate with a better functional outcome compared to k-wiring at 32 months follow up. [13] (10.1016/j.injury.2015.08.040)
- [L5] This review focuses on soft tissue complications encountered during the management of distal radius fractures, including tendon injury, nerve dysfunction, vascular compromise, skin problems, compartment syndrome, and complex regional pain syndrome, noting that complications associated with soft tissues may be more problematic than the bone injury itself. [15] (10.1016/j.hcl.2009.11.002)
- [L5] Early accurate diagnosis of intrinsic carpal ligament injuries provides for best outcomes, while delayed diagnosis leads to arthritis within 10 years if not treated. [16] (10.1016/j.hcl.2015.01.003)
- [Paper] DP fragment size is not an indicator of the need for or use of a dorsal approach in DRF fixation. [17] (10.1055/s-0040-1712328)
- [Paper] Pronation effectively increases the proximal 'safe zone' of the nerve, suggesting the forearm should be placed in pronation to minimize the risk of iatrogenic injury. [18] (10.1016/j.injury.2015.01.028)
- [L4] Monteggia fractures can be easily overlooked if radiographs of the elbow are not taken, and pre-existing congenital radial head dislocations can lead to inappropriate surgical intervention. [19] (10.1016/j.injury.2005.08.028)
- [Paper] CT scan should be requested only by experienced hand surgeons in order to help guide treatment, as it does not significantly improve inter- and intra-observer agreement for all classification systems. [20] (10.1016/j.injury.2014.06.017)
- [L5] Early recognition and treatment is associated with improved outcomes. [21] (10.1016/j.hcl.2020.07.012)
References
[1] Management of Complications of Distal Radius Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2014.12.002 [2] Combined median and ulnar nerve palsy complicating distal radius fractures. Orthopaedics & Traumatology: Surgery & Research. 2018. DOI: 10.1016/j.otsr.2018.04.026 [4] Management of Complications of Forearm Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.01.010 [6] Distal Radius Fractures. Hand Clinics. 2005. DOI: 10.1016/j.hcl.2005.04.001 [7] Loss of radial height in extra-articular distal radial fracture following volar locking plate fixation. Orthopaedics & Traumatology: Surgery & Research. 2021. DOI: 10.1016/j.otsr.2021.102842 [8] Does concomitant ulnar styloid fracture and distal radius fracture portend poorer outcomes? A meta-analysis of comparative studies. Injury. 2017. DOI: 10.1016/j.injury.2017.08.061 [9] The Use of Bone Grafts and Substitutes in the Treatment of Distal Radius Fractures. Hand Clinics. 2012. DOI: 10.1016/j.hcl.2012.02.004 [10] External Fixation of Distal Radius Fractures. Hand Clinics. 2010. DOI: 10.1016/j.hcl.2009.08.008 [11] Distal radius fracture metaphyseal comminution: A new radiographic parameter for quantifying, the metaphyseal collapse ratio (MCR). Orthopaedics & Traumatology: Surgery & Research. 2013. DOI: 10.1016/j.otsr.2013.05.002 [12] Radiographs Versus Radiographic Measurements in Distal Radius Fractures. Journal of Hand and Microsurgery. 2015. DOI: 10.1007/s12593-014-0164-0 [13] Volar plate versus k-wire fixation of distal radius fractures. Injury. 2016. DOI: 10.1016/j.injury.2015.08.040 [15] Soft Tissue Complications of Distal Radius Fractures. Hand Clinics. 2010. DOI: 10.1016/j.hcl.2009.11.002 [16] Management of Complications of Ligament Injuries of the Wrist. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.01.003 [17] The Die Punch Fragment: Analysis of Fragment Geometry and Need for Fixation. Journal of Hand and Microsurgery. 2022. DOI: 10.1055/s-0040-1712328 [18] The course of the posterior interosseous nerve in relation to the proximal radius: Is there a reliable landmark?. Injury. 2015. DOI: 10.1016/j.injury.2015.01.028 [19] When is a Monteggia fracture not a Monteggia fracture?. Injury Extra. 2007. DOI: 10.1016/j.injury.2005.08.028 [20] Does the CT improve inter- and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures?. Injury. 2014. DOI: 10.1016/j.injury.2014.06.017 [21] The Essex-Lopresti Injury:. Hand Clinics. 2020. DOI: 10.1016/j.hcl.2020.07.012
