Fracture assessment and decision making
These are complete articular fractures of the radius. As these are intraarticular fractures, they should be treated with anatomic reduction and absolute stability to minimize the risk of subsequent degenerative changes in the joint.
Anatomical reduction and stabilization of these articular fractures is also essential because of the functional implications of the involvement of the distal radioulnar joint.
The simple articular fracture is associated with a multifragmentary metaphyseal component, so fixation should aim to restore length, axis and rotation. The function of the plate is bridging the comminution and promoting secondary healing with callus formation.
Plate fixation may be applicable for all complete articular fractures, except in unfit or low demand patients. Most of these fractures will be fixed with a palmar plate, but if a dorsal approach is required to treat a carpal injury, or if there is a problem with the palmer soft tissues, a dorsal plate may be chosen.
If the articular surface is accurately reduced, and is fixed in the correct position in relation to the radial shaft, it is not necessary to fix all the metaphyseal fragments and the plate may be used in a bridging mode.