DRF classification and Q/A
Moderator(s): Steven Kelham
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DRF classification and Q/A 0 S. Kelham An 84y/o RHD Female presents to your orthopedic urgent care with acute wrist pain and swelling for the past 48hrs. She reports a FOOSH (fall on outstretched hand) type injury when she tripped over the corner of her ottoman in the living room. She was immediately incapacitated by pain and unable to bear weight. The patient’s initial exam demonstrates swelling and tenderness at the wrist with very limited active motion. She guards against passive motion and is extremely tender throughout the joint. An AP, Lateral and oblique radiograph of the wrist demonstrates a well demarcated transverse fracture line at the base of the distal radius (DR). There is a small fragment fracture of the ulnar styloid as well. The DR fracture DID NOT extend into the intrarticular space. Further cross sectional imaging was not necessary for diagnosis and treatment. #1- Can you name the fracture classification? #2- How would you immobilize the patient awaiting surgical stabilization? #3- Does this injury need surgical stabilization? #3- What is the most likely prognosis for this injury?         Answer 1. Frykman I-VIII, This particular pattern is a Frykman Type II 2. In line immobilization with bracing or splinting. A sugar tong type splint for initial immobilization, soft tissue rest. 3. Generally this is a stable fx pattern and will heal in 3-4 months with casting and bracing 4. Post-Traumatic Arthritis and possibly neurologic sequelae.
by S. Kelham
Monday, March 25, 2019