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1Preliminary remarks

Fracture assessment and decision making

In these injuries, there is a fracture of the distal metaphysis with dorsal displacement. These are often referred to as Pouteau or Colles fractures.

Fractures angulated dorsally >25° associated with osteoporosis or residual void after reduction may prove unstable. Therefore, primary palmar plating may be chosen.

Before palmar plating became a commonly used treatment, most of these fractures were treated with closed reduction, which was then maintained either with K-wires or a plaster cast. Many surgeons now treat most of these fractures with a palmar plate and often use the plate as an aid to reduction.