Các Điều trị gãy xương không ổn định bán kính xa tiếp tục cải thiện tốt hơn như phương pháp định hình xương và mô mềm quản lý đang phát triển. Ngoài giảm đóng cửa và qua da ghim phiên bản của mẫu gãy xương đơn giản, Ba phương pháp chính của quản lý được định hình bên ngoài, | Volar Fixed-Angle Plating of the Distal Radius Dean W. Smith MD and Mark H. Henry MD Abstract The treatment of unstable distal radius fractures continues to improve as better methods of skeletal fixation and soft-tissue management are developed. Apart from closed reduction and percutaneous pinning of simpler fracture patterns the three main methods of management are external fixation dorsal plating and volar fixed-angle plating. Specific advantages of volar fixed-angle plating include stable fixed-angle support that permits early active wrist rehabilitation direct fracture reduction and fewer soft-tissue and tendon problems. Volar fixed-angle plating also avoids the complications often associated with external fixation and dorsal plating. Biomechanical data indicate that when loaded to failure volar fixed-angle plates have significant strength advantages over dorsal plating. Volar fixed-angle plating is advantageous in elderly osteopenic patients and for high-energy comminuted fractures and malunions requiring osteotomy. J Am Acad Orthop Surg 2005 13 28-36 As the population ages and as sporting pursuits become more varied the number of distal radius fractures continues to increase. Although patients with Colles fracture were once thought to do well with nonsurgical treatment this attitude has changed with growing appreciation of the variations of bony and soft-tissue injuries as well as the potential for morbidity. Restoring anatomic articular congruity of the distal radius is critically Beyond the use of pins alone or pins and plaster external fixation has been a major improvement in treating unstable distal radius fractures. External fixation depends on ligamento-taxis through distraction to indirectly control fracture fragments. It provides rigid immobilization from the forearm to the metacarpal but not necessarily reduction or any direct control of articular fragments. Supplemental bone graft and additional Kirschner wires are often used in .
