Fractures of the distal metaphysis can be transverse, oblique, or comminuted.
Stable undisplaced fractures can be treated nonoperatively. Any displacement or instability will usually require ORIF.
Other indications for ORIF are open fractures, or soft-tissue lacerations. In these cases, ORIF is the best option.
|Minimally displaced and/or stable|
- Open fractures
- Rotationally unstable fractures
|Compression plate fixation|
|Open fracture or gross displacement|
- Poor soft tissues
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|