Minimally invasive reduction and osteosynthesis of articular fractures of the distal radius

Treatment of displaced fractures of the distal radius has changed over the course of time. For many years, closed reduction with plaster immobilizatio n was considered the treatment of choice. Subsequent use of pins and plaste r, percutaneous pin fixation, and the development of external fixation devi ces all contributed to improving fracture stability. More recently a new ge neration of external fixation devices has been developed to permit distract ion and palmar translation. In addition, over the past twenty years, we hav e seen the development of more sophisticated internal fixation devices for the treatment of displaced fractures of the distal radius. The indications for open reduction and internal fixation have been defined largely on the b asis of numerous studies which support the concept that articular mal-reduc tion is predictive of traumatic arthritis and poor functional result. Knirk and Jupiter [32] have reported poor results for intra-articular fractures of the distal radius having an articular step-off greater than 2 mm. More r ecently, wrist arthroscopy has been used to improve visualization of articu lar surfaces and aid fracture reduction. In addition, bone grafting techniq ues have been employed more frequently to accelerate fracture healing [29-3 1]. With improvement in techniques, we are able to provide our patients wit h better functional results and return them to their activities of daily li ving and vocation more rapidly.