PANORAMIC REVIEW OF DISTAL RADIUS FRACTURES

Abstract

Introduction: fractures affecting the distal radius are common, their incidence increases as life expectancy increases, leading to a larger population of individuals at risk of suffering these injuries. They are usually comminuted and intra-articular fractures that are outside the traditional eponymous classification.

Objective: to detail current information related to distal radius fractures epidemiology, anatomy, mechanism of injury, clinical evaluation, classification, imaging evaluation, treatment and complications.

Methodology: a total of 27 articles were analyzed in this review, including review and original articles, as well as clinical cases and books, of which 19 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: distal radius fractures, radius anatomy, Colles fracture, Smith fracture, Barton fracture, treatment of distal radius fractures.

Results: distal radius fractures account for about one sixth of all fractures treated in the emergency department, the incidence of distal radius fractures in the elderly correlates with the degree of osteopenia and increases with increasing age. The volar ligaments are stronger and provide greater stability to the radiocarpal joint compared to the dorsal ligaments. The most common mechanism is a fall on the hand in extension with the wrist in dorsiflexion. Currently, there is no consensus on the most optimal classification system for distal radius fractures.

Conclusions: knowing correctly the whole picture of distal radius fractures allows to have a better performance when treating them. It is essential not to overlook in the physical examination the exploration of the ipsilateral elbow and shoulder to rule out the presence of associated injuries and to perform a complete evaluation to detect other possible injuries or life-threatening problems. Distal radius fractures can be treated conservatively or surgically depending on several factors, so classification is essential. There are multiple alternatives in surgical treatment, so the most appropriate one should be chosen for each case. The most common complications in this type of fracture are median nerve dysfunction, post-traumatic osteoarthritis, malunion or pseudoarthrosis and stiffness of the fingers, wrist and elbow.