Skip to main content
SpringerLink
Log in

Implantology of Distal Radius and Distal Ulna Fractures

  • Reference work entry
  • First Online:
Handbook of Orthopaedic Trauma Implantology

  • 28 Accesses

Abstract

Distal radius fractures are very commonly encountered in orthopaedic practice. However, there is no consensus regarding the treatment of these fractures. Literature is divided on the best way to treat these fractures. While some studies have reported satisfactory functional outcome despite poor radiological appearance, other studies have stressed on accurate restoration of radial height, inclination, palmar tilt, and DRUJ stability to obtain a satisfactory final functional outcome.

Though many fractures can be treated with manipulation and a suitable cast, there are many unstable fracture configurations which need operative intervention.

Distal radius fractures show a characteristic bimodal distribution. Low-energy ground level falls tend to cause extra-articular fractures among the elderly with osteoporotic bone. High-energy trauma in younger patients causes displaced, unstable fractures, often with intra-articular involvement. It is important to recognize these two entirely different fracture subsets, as the latter group is more likely to need operative intervention.

Our understanding of distal radius fracture configurations has increased significantly in the past few years, particularly with the advent of CT scans. Improvement in metallurgy and implant designs has led to availability of several implants, each with its own design philosophy and indications. This chapter explains the rationale of design and principles of use of commonly available implants to treat fractures of the distal radius and ulna.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 1,599.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,599.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rayhack JM. The history and evolution of percutaneous pinning of displaced distal radius fractures. Orthop Clin North Am. 1993;24:287–300.

    Article  CAS  PubMed  Google Scholar 

  2. Murray D. Treatment of fractures of the carpal end of the radius by traction. Am J Surg. 1938;44:135–8.

    Article  Google Scholar 

  3. Bohler L. Treatment of fractures. Vienna: Wilhelm Maudrich; 1929.

    Google Scholar 

  4. Kapandji A. Bone fixation by double percutaneous pinning. Functional treatment of non-articular fractures of the distal radius. Ann Chir Main. 1976;6:903–8.

    Google Scholar 

  5. Kapandji A. Internal fixation by double intrafocal pinning. Functional treatment of non-articular fractures of the lower end of the radius. Ann Chir Main. 1987;6:57–63.

    Article  CAS  PubMed  Google Scholar 

  6. Taras J, et al. Use of the T-Pin in the treatment of extra-articular distal radius fractures – Text book – Fracture and injuries of the distal radius and carpus – the cutting edge – David Slutsky and Lee Osterman.

    Google Scholar 

  7. Capo J, et al. External fixation techniques for distal radius fractures. Clin Orthop Relat Res. 2006;445:30–41.

    Article  PubMed  Google Scholar 

  8. McQueen MM. Non-spanning external fixation of the distal radius. Hand Clin. 2005;21:375–38.

    Article  PubMed  Google Scholar 

  9. Danis R. Théorie et pratique de l’ostéosynthèse. Paris: Masson; 1949.

    Google Scholar 

  10. Bagby GW, Janes JM. The effect of compression on the rate of fracture healing using a special plate. Am J Surg. 1958;95:761–71.

    Article  CAS  PubMed  Google Scholar 

  11. Müller ME, Allgöwer M, Willenegger H. Technique of internal fixation of fractures. Berlin: Springer; 1965. Compression fixation with plates; p. 47–51.

    Book  Google Scholar 

  12. Schenk R, Willenegger H. Morphological findings in primary fracture healing. In: Krompecher S, Kerner E, editors. Callus formation symposium on the biology of fracture healing. Budapest: Akadémiai Kiadó; 1967. p. 75–86.

    Google Scholar 

  13. Sürer P. Un nouveau matériel d’ostéosynthèse: la plaque à ancrage “SURFIX”® : son utilisation dans les ostéosynthèses métaphyso-épiphysaires du genou. Ann Orthop Ouest. 1995;27:125–8.

    Google Scholar 

  14. Tepic S, Perren SM. The biomechanics of the PC-Fix internal fixator. Injury. 1995;26(Suppl 2):S-B5–10.

    Article  Google Scholar 

  15. Sommer C. Locking compression plate – LCP – a new AO principle. Injury. 2003;34(Suppl 2):1–76.

    Google Scholar 

  16. Jupiter JB. Current concepts review: fractures of the distal end radius. J Bone Joint Surg. 1991;73:461–9.

    Article  CAS  PubMed  Google Scholar 

  17. Cronier P, Pietu G, et al. The concept of locking plates. Orthop Traumatol Surg Res. 2010;96:S17.

    Article  Google Scholar 

  18. Inagaki K, Kawasaki K. Distal radius fractures design of locking mechanism in plate system and recent surgical procedures. J Orthop Sci. 2016;21:258–62.

    Article  PubMed  Google Scholar 

  19. Orbay J, Badia A, et al. Volar fixed-angle fixation of distal radius fractures: the DVR plate. Tech Hand Upper Extrem Surg. 2004;8(3):142–8.

    Article  Google Scholar 

  20. Fernandez DL, Giessler WB. Treatment of displaced articular fractures of the radius. J Hand Surg Am. 1991;16(3):375–84.

    Article  CAS  PubMed  Google Scholar 

  21. Medoff RJ, Kopylov P. Immediate internal fixation and motion of comminuted distal radius fractures using a new fragment specific fixation system. Orthop Trans. 1998;22:165.

    Google Scholar 

  22. Leslie B, Medoff R. Fracture specific fixation of distal radius fractures. Tech Orthop. 2000;15:336–52.

    Article  Google Scholar 

  23. Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg Br. 1996;78(4):588–92.

    Article  CAS  PubMed  Google Scholar 

  24. Lee J, Cho J, Lee S. The effects of the frag-loc compression screw on distal radius fracture with a displaced dorsoulnar fragment. Arch Orthop Trauma Surg. 2015;135(9):1315–21.

    Article  PubMed  Google Scholar 

  25. Schlickum L, Leixnering M, et al. Three-dimensional kinematics of the flexor pollicis longus tendon in relation to the position of the FPL plate and distal radius width. Arch Orthop Trauma Surg. 2019;139(2):269–79.

    Article  CAS  PubMed  Google Scholar 

  26. Di Maggio B, Caforio M, et al. PEEK radiolucent plate for distal radius fractures: multicentre clinical results at 12 months follow up. Injury. 2017;48(Suppl 3):S34–8.

    Article  PubMed  Google Scholar 

  27. Windisch G, et al. Promontory of radius: a new anatomical description on the distal radius. Surg Radiol Anat. 2007;29(8):629–33.

    Article  CAS  PubMed  Google Scholar 

  28. Nelson D. Anatomy notes and their clinical significance for the volar approach by David L. Nelson, MD. 2013. http://www.davidlnelson.md/articles/Radius_Anatomy_Annotated.htm

  29. Gasse N, Obert L, Francois L. Distal radius anatomy applied to the treatment of wrist fractures by plate: a review of recent literature. SICOT J. 2015;1:14.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Imatani J, et al. An anatomical study of the watershed line on the volar, distal aspect of the radius: implications for plate placement and avoidance of tendon ruptures. J Hand Surg. 2012;37(8):1550–4.

    Article  Google Scholar 

  31. Goorens CK, Goubau J, et al. Midterm follow-up of treating volar marginal rim fractures with variable angle LCP volar rim distal radius plates. J Hand Surg Asian Pac. 2017;22(2):184–7.

    Article  Google Scholar 

  32. Soong M, Earp BE, Bishop G, Leung A, Blazar P. Volar locking plate implant prominence and flexor tendon rupture. J Bone Joint Surg Am. 2011;93(4):328–35.

    Article  PubMed  Google Scholar 

  33. Lauder A, Huang J, et al. Functional outcomes following bridge plate fixation for distal radius fractures. J Hand Surg Am. 2015;40(8):1554–62.

    Article  PubMed  Google Scholar 

  34. Brink PRG, Rikli DA. Four-corner concept: CT-based assessment of fracture patterns in distal radius. J Wrist Surg. 2016;5(2):147–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Rancy SK, Malliaris SD, Wolfe S, et al. Intramedullary fixation of distal radius fractures using CAGE-DR implant. J Wrist Surg. 2018;07(05):358–65.

    Article  Google Scholar 

  36. Brooks KR, Capo JT, Warburton M, et al. Internal fixation of distal radius fractures with novel intramedullary implants. Clin Orthop. 2006;445:42–50.

    Article  PubMed  Google Scholar 

  37. Lafontaine M, Hardy D, Delincé PH. Stability assessment of distal radius fractures. Injury. 1989;20:208–10.

    Article  CAS  PubMed  Google Scholar 

  38. Nunez F Jr, Campbell D, Zhongyu L, Nunez F Sr. Distal ulna hook plate: angular stable implant for fixation of distal ulna. J Wrist Surg. 2013;2(1):87–92.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Hazel A, Nemeth N, Bindra R. Anatomic considerations for plating of the distal ulna. J Wrist Surg. 2015;4(3):188–93.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Nemeth N, Bindra R. Fixation of distal ulna fractures associated with distal radius fractures using intrafocal pin plate. J Wrist Surg. 2014;3(1):55–9.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Apollo Gleneagles Hospitals, Kolkata, India

    Ravi Ganesh Bharadwaj

Authors
  1. Ravi Ganesh Bharadwaj
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. NH Narayana Superspeciality and Multispeciality Hospitals, Howrah, West Bengal, India

    Arindam Banerjee

  2. Technical University of Munich, Munich, Germany

    Peter Biberthaler

  3. Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

    Saseendar Shanmugasundaram

Section Editor information

  1. Dept. of Orthopaedics, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India

    Ravi G. Bharadwaj

  2. Sri Dhaatri Orthopaedic, Maternity & Gynaecology Center, Vijayawada, India

    Srinivas B. S. Kambhampati

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Singapore Pte Ltd.

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Bharadwaj, R.G. (2023). Implantology of Distal Radius and Distal Ulna Fractures. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_73

Download citation

  • DOI: https://doi.org/10.1007/978-981-19-7540-0_73

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-7539-4

  • Online ISBN: 978-981-19-7540-0

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation