by Alejandro Badia, MD
It was not too long ago that the standard of care for a distal radius fracture with displacement was the application of an external fixator. Like the brief internment in a penal colony, the patient was left to deal with this cumbersome device for several months. I highly doubt that many of the little old ladies who had this device applied appreciated its “minimally invasive” nature.
Over 10 years ago, I remember my partner and I applying the standard volar plate from the synthes set to ALL distal radius fractures, regardless of direction of displacement. I think neither Mrs. Smith nor Mrs. Colles cared about their Frykman classification but likely appreciated the fact that a small palmar based plate on the wrist, as an outpatient under regional anesthesia, could allow them to get right back to their daily routine simply using a small splint or fiberglass cast as protection.
I remember just a few years later lecturing on this very topic in Ho Chi Minh City, or even Buenos Aires, and realizing that this had very quickly become the standard of care worldwide. It was gratifying to be part of a revolution that truly improved patient care of this ubiquitous fracture.
Alejandro Badia, MD
Miami, FL, USA