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The Journal of Bone and Joint Surgery (American) 80:582-600 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Intra-Articular Fractures of the Distal Aspect of the Radius*{dagger}

THOMAS E. TRUMBLE, M.D.{ddagger}, SEATTLE, RANDALL CULP, M.D.§, PHILADELPHIA, PENNSYLVANIA, DOUGLAS P. HANEL, M.D.#, SEATTLE, WASHINGTON, WILLIAM B. GEISSLER, M.D.**, JACKSON, MISSISSIPPI and RICHARD A. BERGER, M.D.{dagger}{dagger}, ROCHESTER, MINNESOTA

An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons

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   Introduction
 
High-energy injuries frequently cause shear and impacted fractures of the articular surface of the distal aspect of the radius with displacement of the fracture fragments. Even fractures with a small amount of displacement can result in degeneration of the joint, causing pain and stiffness of the wrist. The fracture pattern, degree of displacement of the fracture fragments, and stability of the fracture determine whether operative treatment rather than immobilization with a cast is needed. The options for operative treatment include open reduction and internal fixation, to realign the articular surface of the radius; external fixation, for fractures with comminution of the metaphysis of the radius, to maintain the length of the radius; and bone-grafting, to provide support for the articular surface of impacted fractures.


   Anatomy of the Articular Interface between the Distal Aspects of the Radius and Ulna and the Carpus
 
The articular surface of the distal aspect of the radius tilts 21 degrees in the anteroposterior plane and 5 to 11 degrees in the lateral plane . . . [Full Text of this Article]


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