Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Refer a patient with a wrist fracture to secondary care for surgical intervention if the fracture is dorsally displaced and surgical fixation is indicated. Surgical fixation is recommended when:
- There is no fracture of the articular surface of the radial carpal joint or displacement of the radial carpal joint can be reduced by closed manipulation, in which case K-wire fixation is offered.
- Closed reduction of the radial carpal joint surface is not possible, in which case open reduction and internal fixation should be considered.
- In children with dorsally displaced distal radius fractures that are completely displaced (off-ended), K-wire fixation is considered after manipulation.
- Surgery should be performed within 72 hours of injury for intra-articular distal radius fractures and within 7 days for extra-articular fractures.
These criteria help identify patients who require surgical management rather than conservative treatment such as manipulation and plaster cast.
References: NICE NG38