Executive Editor: Steve Krikler

Authors: Renato Fricker, Jesse Jupiter, Matej Kastelec

Distal forearm Extraarticular wedge or multifragmentary fracture of the radius - Closed reduction - K-wires and cast

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Functional exercises

As soon as possible, the patient should be encouraged to elevate the limb and mobilize the digits, elbow and shoulder.

If necessary, functional exercises can be under the supervision of a hand therapist.

Follow up

See patient 7-10 days after surgery for a wound check and/or suture removal. X-rays are taken to check the reduction. Refer to your local protocol for timing of X-ray follow-up.

K wire removal

The K-wires are usually removed at about 6-8 weeks. If the wires were buried, it may be necessary to take the patient to the OR to reopen the incisions and retrieve the wires.

Cast removal

The cast is left in place for 4-6 weeks. An x-ray will document fracture position at this time.

Exfix management

The patient needs to be instructed in pin care and should clean the insertion sites daily.

The external fixator is usually left in place for six weeks, but in very unstable fractures or where there are delays in fracture healing it may be left for longer. Excessively long application of an external fixator risks joint stiffness.

The timing of external fixator removal is influenced by various factors. These include the specific details of the fracture and patient, and the radiological appearance of the healing fracture.