60 - Distal Radius Fractures

Abstract

Distal radius fractures are the most common upper extremity fracture in patients in the United States,1 accounting for 0.7%–2.5% of emergency department visits. Worldwide, the incidence of distal radius fractures has increased over the past 40–50 years, almost doubling in certain populations. Distal radius fractures occur in a bimodal distribution with the highest frequency in youths under the age of 18 years and a secondary peak in adults over 50 years old. In the older adults, osteoporosis and poor postural stability are associated with these fractures after falls onto an outstretched hand. Increasing age and obesity levels are risk factors for more complex injury patterns. Distal radius fractures in young patients usually occur in the setting of play or sports and account for 23% of all sports-related fractures in adolescents. Regardless of patient age, comorbidity burden, or fracture pattern, the overall principles in management remain the same. First, the fracture must be stabilized and any secondary injuries evaluated. Next, the determination of operative versus nonoperative treatment must be made. Currently, the most common surgical procedure for distal radius fractures in adults is open reduction and internal fixation with a volar plate, but the specific procedure should be tailored to individual patients and their injuries.