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10<br />
1) Closed reduction:<br />
- longitudinal traction<br />
- palmar flexion<br />
- ulnar inclination<br />
METHODS<br />
2) Direct nailing (ORIF):<br />
- lowering consolidation time<br />
and immobilization time (6-8w)<br />
- for radial styloid, posteromedial fragments<br />
and stbilizing the radio-ulna joint (pronosupination)<br />
METHODS<br />
3) Direct osteosynthesis (internal fixation):<br />
- includes special plates and screws<br />
- Anterior / posterior approach (if palmar large<br />
bone loss)<br />
- Can include bone graft (Radius, Iliac crest)<br />
to stabilize fragments<br />
4) External fixation:<br />
- nesscitates preliminar closed reduction<br />
- ligamentotaxis<br />
- duration of 3-8w; if consolidates enough- remove & cast 2w<br />
afterwards mobile cast<br />
- technique: reduction under Rx vision<br />
longitudinal traction -> neutralize articulation<br />
palmar flexion?<br />
mild extension (8º)<br />
Stable fractures<br />
No displacement<br />
CI to surgery<br />
Unstable<br />
Few large<br />
fragments<br />
Unstable<br />
Multiple fragments<br />
Melone V<br />
Unstable<br />
Multiple fragments
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