Rockwood Children CH8

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CHAPTER 8 • Fractures of the Distal Radius and Ulna

Distal radius fracture

Bicortical

Physeal

Intra-articular

Torus

Incomplete

Nondisplaced

Nondisplaced

Nondisplaced

Displaced*

Acute displaced*

Closed reduction cast

Splint 3 wks

Closed reduction cast

Nonacute displaced*

Cast 6 wks

Cast

Cast 6 wks

Neurovascular compromise?

Serial x-rays

CRPP, fasciotomies

Cast 6 wks

Maintained reduction

Lost reduction

Cast 6 wks

No follow-up

Remanipulation Cast wedging CRPP ORIF

6–12 month follow-up

No follow-up

Distal radius fracture

Intra-articular

Nondisplaced

Displaced**

Closed reduction

CT/MRI

Nondisplaced

Displaced**

Cast

ORIF

Serial x-rays

Algorithm 8-1.  CRPP, closed reduction and percutaneous pinning; ORIF, open reduction and internal fixation; CT, computed tomography; MRI, magnetic resonance imaging.