chapter  24
12 Pages

Repair of Distal Radial Malunions with an Intramedullary Nail

Fractures of the distal radius are one of the most common

fractures that are treated by orthopedic surgeons. They

account for up to 20% of all fractures seen in the emergency

department (1,2). There is a bimodal age distribution, occurring

most commonly between the ages of 5 to 14 and 60 and 69 years.

Within the second age group, there is a predominance of female

patients with a ratio of approximately 4:1. Also within this age

group, the fracture is usually the result of a low energy injury;

typically the patient presents after a fall on an outstretched

hand. The accelerating body weight produces a bending

moment on the distal forearm, and the distal radius fails

through the softer metaphyseal bone. The result usually is a

displaced, extraarticular metaphyseal fracture of the distal

radius. Extraarticular distal radius fractures without significant

comminution typically prove to be stable after closed reduction

and are usually amenable to cast immobilization.