Contents
Common in icy weather and osteoporotic roller-bladers.
The Deformity:
- Dorsal displacement
- Dorsal tilt (volar angulation)
- Radial displacement
- Radial tilt
- Shortening
- Ulnar styloid fracture
Treatment:
Reduction may not be necessary if the fracture is minimally displaced. In this event simply apply a dorsal and radial plaster splint.
Reduction aims to correct the above deformities.
- Haematoma Block – full sterile prep. and drape. Inject into # site from dorsally. Use 5-10 ml 1% Lidocaine
- Traction – for 2-3 minutes. Pull toward ulnar side.
- Flex Distal Fragment – NOT THE WRIST!!
- Apply splint and MOULD WELL!!!
Note: It is essential to examine and document neurovascular status prior and following the treatment. Specifically, motor and sensory function of radial, ulnar and median nerve should always be examined.
|
|
Radial |
Ulnar |
Median |
|---|---|---|---|
|
Motor |
No intrinsic muscles, can be tested by extending the fingers |
Finger abduction |
Thumb 90° abduction |
|
Sensory |
Dorsal thumb webspace |
Ulnar aspect of little finger |
Index finger |
Aims:
1. Distal radius articular surface to neutral (restore normal volar tilt of 11-12 degrees and radial inclination of 23 degrees).
2. Out to length (restore normal radial height of 11-12mm).
Note: Make sure you get a post-reduction film IMMEDIATELY in case a repeat reduction is needed. The haematoma block will work for about 1 hour.
See also:
Radiologic evaluation of a distal radius fracture – What junior doctors should know
Attachments:
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