- See:
Radiographic Findings
- Unstable Frx Patterns:
-
Barton's frx,
Radial-styloid frx, and
Smith's frx, will often be unstable;
-
dorsal angulation: > initial 20 deg implies instability;
-
radial shortening of 5 mm or more;
-
articular frxs that involve radiocarpal joint;
- more than 2 mm of articular step off is associated w/ poor prognosis;
- radio-carpal
instability (most often
DISI deformity);
- involvement of
distal radio-ulnar joint;
- there may be dislocation of the ulna from the sigmoid notch;
- comminution:
- dorsal surface is frequently comminuted;
- if comminution extends volar to midaxial plane of radius, then cast immobilization will frequently fail;
- expect increase in comminution w/ incr in amount of dorsiflexion;
- high-loading angles, (70-90 deg), have much more comminution than low loading angles of 20 to 40 deg;
- Clinical Consequences:
- these frxs are assoc w/ higher rate of complications, including loss of reduction,
median nerve
injury, and instability of the distal radioulnar joint;
- Secondary Instability:
- present when closed reduction & cast immobilization fails to maintain initial reduction;
- residual
dorsal angulation of > 10 deg;
-
radial shortening of 5mm;
