Management of distal radio fractures at the emergency room

Abstract

Distal radius fractures are the most common in adults. The criteria to define whether its management is surgical, or conservative are not entirely clear. Traditionally, the Lafontaine criteria have been established as the tool to segregate patients who require surgical management from those who can be managed conservatively. The current literature shows us that the only criteria that really predict the possible displacement of a Distal Radius fracture are the dorsal comminution, female gender, and age greater than 60 years. Intra-articular tracings may not predict instability, but they should be taken as definitive criteria for surgical management due to early associated osteoarthritis in patients who are not operated on. Even though age over 60 years is a criterion that predicts displacement, it should rather be considered as a factor against surgery, since the evidence shows that after 12 months, the functional results are the same in operated patients and those managed with immobilization.