Intramedullary Fixation of Distal Radius Fractures

Intramedullary fixation has recently received increased enthusiasm as an option for distal radius fracture fixation. Indications for this fracture fixation technique should be limited to predominately displaced extra-articular or simple intra-articular distal radius fractures. Intramedullary fixation permits limited soft tissue dissection and insertion of a low-profile implant that acts as an internal splint. Purported benefits include a familiar fracture fixation technique, less soft tissue irritation, and locked fixed-angle technology. Thorough understanding of the radial and dorsal approaches to the distal radius is a prerequisite. Important aspects of intramedullary fixation of distal radius fractures include proper fracture selection, good fracture reduction, protection of sensory nerves, and avoidance of inadvertent intra-articular screw placement. Relevant surgical anatomy, technique, postoperative care, and a review of complications are presented. (J Hand Surg 2009;34A:341-346. (C) 2009 Published by Elsevier Inc. on behalf of the American Society for Surgery of the Hand.)