Distal Radius Open Fractures

  • Which type of fracture generally accompanies distal radius open fractures?

a) 1 b) 2   c) 3A   d) 3B   e) all of them have the same ratio

Which one of the below is the most important infection indicator after a distal radius open fracture?

a)      Degree of contamination

b)      Degree of open fracture

c)      Type of the fracture

d)     The time passed until the incision

e)      The choice of antibiotics

-After a distal radius open fracture, when debridement and fixation should be applied?

– After the first debridement, will fixation with a plate be safe or should we apply temporary or permanent external fixator application?

Recent Opinion

According to the patient’s medical condition, debridement should be applied in the shortest amount of time in open fractures. At the same time (if patient came to the hospital at night, then it can be done as first thing of the next morning) it should be fixed. If the injury isn’t much contaminated, then it can be fixed with a plate.

Lack of Proof and the Future

In the distal radius open fractures, recent treatments are determined by the literatures about open hand and forearm injuries.

Ideally, it should be determined by multicentre, forward looking and controlled studies. Most frequent is the type 1 open fractures and these patients’ infection rates are so low that it’s hard to perform a study on them.

Personal Opinions

  • Type 1 radius open fractures are higher energy fractures compared to the closed ones.
  • Compared to type 2 and type 3 injuries the time of debridement is less important.
  • In type 1 injuries, after rapid debridement, external fixator and fixation with plate applications, formation of soft tissue may affect the functional results negatively.
  • If it’s not contaminated to a higher degree and if there isn’t any avascular tissue formation, then you can first apply internal fixation.
  • If you can’t decide an accurate treatment, then a secondary opinion can be used.

Answers: 1:a    2:a