Distal radius fractures

Prijelomi distalnog radijusa jedni su od najčešćih prijeloma; predstavljaju 10-17% svih prijeloma, točnije 75% prijeloma ruke. Riječ je o prijelomu palčane kosti podlaktice koji se najčešće vidi kod mlađe muške djece i starijih žena. Razlog takvoj raspodjeli leži u činjenici da dječaci češće padaju prilikom bavljenja sportom dok su starije žene zbog osteoporoze posebno podložne ovoj ozljedi. Najčešći mehanizam je pad na dlan ruke u dorzalnoj fleksiji. Tako nastaje tipičan Collesov tip prijeloma, gdje je distalni frakturni fragment pomaknut dorzalno, a ujedno je najčešći tip prijeloma s incidencijom od 90%. Drugi tip je Smithov prijelom (5%), koji nastaje direktnim udarcem u dorzalnu stranu podlaktice ili padom na ruku u palmarnoj fleksiji. Distalni frakturni fragment je pritom pomaknut volarno. Bartonov prijelom (2%) je intraartikularni prijelom distalnog radijusa sa dislokacijom radiokarpalnog zgloba. Prijelom se potvrđuje rendgenskom snimkom u dvije projekcije, AP i latero-lateralnom, te se nakon toga odlučuje o daljnjem liječenju. Većina ovih ozljeda se liječi repozicijom i sadrenom imobilizacijom u trajanju od 6 tjedana, dok je kod manjeg broja bolesnika indicirano kirurško liječenje. Opcije kod kirurškog liječenja su perkutarna fiksacija, minimalno invazivna otvorena repozicija, vanjski fiksator i otvorena repozicija i unutarnja fiksacija. Oporavak je uglavnom dobar, s ponekim mogućim komplikacijama i većinom potpunim oporavkom tijekom 3-6 mjeseci.Fractures of the distal radius are one of the most common fractures; they account for 10-17% of all the fractures, more accurately 75% of the fractures of the arm. It is a fracture of the radius in the forearm which is most frequently seen in young males and older women. Reason for this distribution lies in the fact that boys fall more often during sport activities while older women because of osteophorosis are specially subjected to this type of injury. The most common mechanism of injury is by falling on the palm of the hand in dorsal flexion. That's how a typicall Colles' fracture occurs, where the distal fracture fragment is displaced dorsally and it is the most common distal radial fracture, with an incidence of 90%. The second type is Smith's fracture (5%), caused by a direct blow to the dorsal forearm or falling on the hand in palmar flexion. The distal fracture fragment is displaced volary. A Barton's fracture (2%) is an intraarticular fracture of the distal radius with dislocation of the radiocarpal joint. Confirmation of this injury is obtained by X-ray imaging in two projections, AP and laterolateral and after that it is decided about further treatment. Most types of these injuries are treated with reposition and cast immobilization for 6 weeks, while for a minor part of patients surgical treatment is performed. Options for surgical treatment are percutaneous fixation, limited open reduction, external fixation and open reduction internal fixation. Recovery is usually good, with some minor complications and mostly full recovery during 3-6 months