3 Reasons For Distal Radius Fracture Surgery

So, If you fractured your radius that is this bone over here. You’ll probably have questions such as was the treatment appropriate. You know could this cause pain and arthritis or stiffness in the future. What kind of treatment is necessary and can radius be treated without a surgery? I want to explain three things, When it comes to answering these questions, Three important things as already mentioned this over here is the radius bone. It articulates with the bones of the wrist and with the ulna distally but it also articulates with the ulna more approximally at the elbow joint. It also articulates with the humerus of the elbow joint and it facilitates the insertion of the biceps muscle and therefore it helps perform the flexion at the elbow joint and why are we talking about this bone? Well, Normally when people lose balance and fault in our ground they tend to fall on their wrists in order to preserve some stability during the accident and also to avoid hitting a hard floor or on the ground with their head because of this radius can fracture easily. Almost 25 percent of all the fractures are the distal radius fractures. Now, If we look at this region from the Palmer View and remove the skin and the underlying tissue you might notice that there are many structures here, this, which you can see here is the transverse carpal ligament underneath that ligament. There is the median nerve and many tendons around it coming from important muscles of the forearm a little bit more medially, We can see here the ulnar artery providing the important blood supply for the wrist and the hand right next to it is the ulnar nerve and so because of all of these structures so densely packed in this region. It is quite understandable unless this bone fracture is treated appropriately. The patient might experience pain arthritis as a consequence of a badly planned treatment of the distal radius fracture. These densely packed tendons in this region are important for mobility of fingers hand and the wrist and therefore if they are affected the patient might lose mobility and experience stiffness in the joint as if that wasn’t enough this region has many bones and barely 30 to 40 percent of distal radius fractures treated in a non-surgical way results in acceptable alignment of the bones. This is the distal part of the radius, here you can see the distal part of the ulna here. The scaphoid bone, The lunate bone, The triquetral bone trapezium and the trapezoid bone capitate and the hemate bone. Furthermore, There are additional five bones over here. The metacarpal bones, one for each finger because of so many little bones involved over here. It can be sometimes hard to achieve a satisfactory level of alignment of these bones. A badly planned therapy of a distal radius fracture can have permanent and serious consequences for the patient. Before I explain these three factors that indicate a necessity for a surgical treatment of the distal radius fracture, I would like to ask you to like this video And subscribe to our Channel. As already explained, This is a common fracture and a lot of people who experience symptoms such as pain and stiffness will not see our video unless you like it and subscribe to our Channel, That’s simply how the algorithms of YouTube and other online platforms work. Furthermore, They will not even show you our videos unless you really go ahead and click that bell button which is quite annoying. So, if you’re already subscribed and like this video, let’s continue one truly important factor that indicates the necessity for a surgery is the age of the patient and the way the radius has healed. We can see that on an example of radial inclination this angle over here is radial inclination and normally it is 23 degrees but a redistal radius fracture can reduce that furthermore, there is a term called Volar Tilt. Now if we were to create a sagittal section through the distal radius. You would notice that the articulating surface of the distal radius is not flat like this instead it is tilted in the volar direction. This way a distal radius fracture can reverse that and cause the so-called dorsal tilt of the articulating surface of the distal radius as you might have noticed joint surfaces and their alignment are really important but it’s not just their alignment that matters it’s also their quality and smoothness that is really important a lot of distal radius fractures actually happens right through the joint surfaces. It means that the surface itself fractured and there was an opening a gap now after the distal radius is repositioned. It could happen that on that joint surface, A step off is present along the lines of the fracture. If the step off is higher than two millimeters then a surgery might be required to fix that and last but not least. The third thing, I wanted to highlight about distal radius fractures a special form of distal radius fractures, The Smith’s fracture as it was already explained most of the distal radius fractures happen as the patients land on their wrists dorsiflexed. Now, This is dorsiflexion of the wrist now that dorsiflexion can be minimally performed or the patients might also land on their wrists completely flexed and that is when Smith’s fractures happen so the first reason I wanted to highlight for a surgical treatment of the distal radius fracture is basically a misalignment of the bones that might appear and we can see that on an example of radial inclination and that is this angle over here which is normally around 23 degrees but it can be reduced if a distal radius fracture has occurred furthermore the second reason I wanted to highlight was a possible step-off that appears as a possible consequence of an intra-articular distal radius fracture where the fracture happened inside of the joint on the joint surfaces as well and if the patient lands on his wrists flexed then he might experience the so-called Smith’s fracture and that is the third reason for a surgical treatment of the distal radius fractures that I wanted to explain. Both of you doctors and patients, We can all benefit from videos like these. If you’re a doctor and you want to make a video like this one then go to anatomsky.com but if you have more questions about bone fractures or distal radius fracture then go to this link symtomsky.com/help/fracture