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. 2020 Nov 20;25(3):156-164.
doi: 10.1097/BTH.0000000000000325.

Management of Metadiaphyseal Proximal Radius Fractures

Leah Demetri  1 , Charlotte Young  2 , Joseph T Patterson  3 , Utku Kandemir  1 , Saam Morshed  1 , Igor Immerman  1 , Nicolas H Lee  1
Affiliations

Management of Metadiaphyseal Proximal Radius Fractures

Leah Demetri et al. Tech Hand Up Extrem Surg. .

Abstract

Metadiaphyseal proximal radius fractures blur the distinction between the radial neck and radial shaft fractures. Operative management presents unique technical challenges both in terms of surgical approach and fixation method. We discuss relevant anatomy, safe surgical approach, and options and techniques for fracture fixation. We describe 6 patients who achieved satisfactory functional outcomes, even in cases of severe bone loss secondary to ballistic trauma. An extensile dorsal approach with exposure of the posterior interosseous nerve is recommended when normal soft tissue intervals have not already been extensively disrupted. Robust fixation can be achieved by contouring and repurposing a variety of plates such as a variety of mini fragment plates (2.4 mm T or Y-plates), flexible nails, or even distal radius plates.

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Conflict of interest statement

Conflict of Interest and Source of Funding: J.T.P. reports research support from AOTrauma North America. I.I. reports stock or stock options in ROM3, payment for presenting or speaking for Skeletal Dynamics, and is a board or committee member American Society for Surgery of the Hand. N.H.L. is a board or committee member American Society for Surgery of the Hand. For the remaining authors none were declared.

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