Distal Radius and Ulna Fractures

Several papers have been published in the last decades regarding distal radius fractures. In this chapter, the most current concepts regarding the management of distal radius fracture are summarized. The chapter includes a brief historical and epidemiological review, as well as a review of the normal and functional anatomy of the distal radius area and the biomechanics of the distal radius and ulna. The most relevant clinical features and diagnostic imaging methods are described in detail for the reader to be able to classify a certain fracture based on objective radiologic and tomographic signs. The authors present the most used and classic classifications: Frykman, AO-ASIF, and Fernández. Nonoperative treatment is described step by step, from noninvasive reduction maneuvers to final rehabilitation. The indications for surgical treatment are also described, including an overview of the different methods of surgical reduction and fixation, depicting the advantages and of each one of them according to the evidence. Surgical treatment options are varied, including K-wires, external fixation, spanning plates, volar nonlocking and locking plates, dorsal plates, cannulated or noncannulated lag screws, intramedullary devices, bone sutures, and bone anchors. Distal radius fracture and treatment complications include malunion, nonunion, soft tissue damage, and other less prevalent complications. Finally, ulnar styloid-associated fractures are discussed, with special reference to their treatment when they accompany distal radius unstable fractures.