Many displaced distal radius fractures that are reduced and casted lose position in the first two weeks. Get radiographs after reduction and again at about one and two weeks. On each film, measure radial inclination, radial height and volar tilt, and compare with the contralateral side if needed. Look for dorsal comminution, older age and initial severe displacement, which predict slipping. Decide at the two-week visit whether alignment is acceptable for the patient's age and function, while fixation is still straightforward.
- Check radiographs after reduction and at about one and two weeks
- Measure radial inclination, radial height and volar tilt on each film
- Note dorsal comminution and severe initial displacement, which predict slipping
- Make the fixation decision by two weeks, while it is still straightforward
Why it matters
Cast-first treatment only works if redisplacement is caught in time.
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