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Distal Radius Fractures
Posted: Sep 24 2020 #(C101585)
A

Distal Radius Fracture in 32M

HPI

The patient presented with the above chief complaint after a fall down steps at home onto an out-stretched left hand. He localized global pain to the left wrist and denies numbness in the hand.

PMH

He is otherwise healthy and works as a manual laborer.

PE

On physical examination, the injury is isolated, closed, with moderate swelling, tenderness globally about the wrist, and an otherwise neurovascularly intact extremity.

Poll
1 of 8
1. In addition to the plain film radiographs shown, would you obtain any further imaging to guide management?
No - current radiographs are sufficient
25%
478/1847
Yes - additional radiographic views (XR)
0%
13/1847
Yes - CT scan of the wrist (CT)
61%
1127/1847
Yes - MRI scan of the wrist (MRI)
1%
23/1847
Yes - XR + CT
7%
133/1847
Yes - XR + MRI
0%
3/1847
Yes - CT + MRI
0%
15/1847
Yes - XR + CT + MRI
0%
9/1847
Outside my area of expertise - best if I don't voteOutside my area of expertise - best if I don't vote
2%
46/1847
2. Would you use a classification system to guide management of this injury?
No - a classification system would not help me
44%
756/1697
Yes - Fernandez
7%
132/1697
Yes - Frykman
10%
179/1697
Yes - Malone
2%
46/1697
Yes - AO/OTA
24%
419/1697
Yes - Other
0%
15/1697
Outside my area of expertise - best if I don't vote
8%
150/1697
3. How would you manage this injury?
Nonoperative (closed reduction, immobilization)
13%
238/1795
Operative
84%
1522/1795
Outside my area of expertise - best if I don't vote
1%
35/1795
4. If you choose Operative management, would you perform a provisional closed reduction prior to surgery?
I would not choose Operative management
3%
55/1660
No
58%
977/1660
Yes
34%
577/1660
Outside my area of expertise - best if I don't vote
3%
51/1660
5. If you choose Operative management, when would you take this patient to surgery?
I would not choose Operative management
1%
28/1694
Same-day
19%
326/1694
<1 week
62%
1054/1694
1-2 weeks
13%
231/1694
>2 weeks
0%
3/1694
Outside my area of expertise - best if I don't vote
3%
52/1694
6. If you choose Operative management, what surgical technique would you use?
I would not choose Operative management
1%
26/1641
External fixation only (ExFix)
0%
5/1641
Closed reduction percutaneous pinning only (CRPP)
6%
108/1641
Open reduction internal fixation only (ORIF)
67%
1101/1641
Dorsal bridge plate only (DBP)
4%
78/1641
ExFix + CRPP
2%
44/1641
ORIF + CRPP
10%
167/1641
DBP + CRPP
2%
38/1641
Outside my area of expertise - best if I don't vote
4%
74/1641
7. If you choose Open reduction internal fixation (ORIF), what approach would you use?
I would not choose ORIF
2%
37/1601
Volar only
45%
732/1601
Dorsal only
19%
313/1601
Volar + Radial
7%
128/1601
Dorsal + Radial
12%
205/1601
Dorsal + Volar
5%
95/1601
Volar + Radial + Dorsal
0%
11/1601
Outside my area of expertise - best if I don't vote
4%
80/1601
8. If you choose Operative management and attained the construct shown, when would you begin range of motion exercises post-operatively?
I would not choose Operative management
1%
20/1476
Immediately
19%
285/1476
1-2 weeks
40%
598/1476
3-4 weeks
26%
385/1476
5-6 weeks
9%
140/1476
7-9 weeks
0%
14/1476
10-12 weeks
0%
2/1476
>12 weeks
0%
1/1476
Outside my area of expertise - best if I don't vote
2%
31/1476
PROCEDURE #1

Open reduction and internal fixation of distal radius fracture

Intra-procedure P1
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OUTCOMES
Post-procedure P1
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