Treatment of Intraarticular Radial Fractures

Surgical Management Options

Volar locked plating is the preferred surgical technique for intraarticular radial fractures, providing earlier functional return in the short term compared to other fixation methods 1, 2
The American Academy of Orthopaedic Surgeons recommends volar locked plate fixation as the primary treatment option for intraarticular radial fractures, leading to better functional outcomes compared to conservative management 1, 2
Other surgical options include dorsal plating, external fixation, and percutaneous fixation with Kirschner wires, but evidence shows no significant difference in long-term outcomes between these techniques 2

Surgical fixation is indicated for fractures with significant displacement, dorsal tilt, or intraarticular involvement with displacement 4

Active finger motion exercises should be performed following surgery to prevent stiffness, which is one of the most functionally disabling adverse effects 4

The American Academy of Orthopaedic Surgeons guidelines indicate that no difference exists in outcomes based on frequency of radiographic evaluation 1
Radiographic follow-up is typically recommended at approximately 3 weeks and at the time of immobilization removal to confirm adequate healing 4

The American Academy of Orthopaedic Surgeons recommends multimodal and opioid-sparing protocols when possible 1, 2
Non-opioid alternatives include local anesthetics, nonsteroidal anti-inflammatory agents, acetaminophen, and non-pharmacologic interventions 2

Immobilization-related adverse events occur in approximately 14.7% of cases and may include skin irritation and muscle atrophy 4