The management of unstable distal forearm fractures: a national survey among orthopedic trauma surgeons from Italy

BACKGROUND: Distal forearm fractures are injuries typically occurring in high-energy trauma in young adults or in low-impact injuries in osteoporotic elderly people. Due to the lack of guidance in the current literature, proper fracture management is very challenging. Distal radioulnar joint (DRUJ) stability is the most disabling complication and is under debate its necessity for surgical reconstruction. This article is based on a survey created to analyze what commonly happens in clinical practice and the aim of the study was providing an algorithm to use for diagnosis and treatment of these fracture.METHODS: A webinar survey was developed: questions were derived from recent literature and an email has been sent to all surgeons subscribed to AO/OTA and AUOT association a few days before the webinar online. A total of 185 orthopedic surgeons in Italy were interviewed.RESULTS: After a review of current literature, a final treatment algorithm has been proposed.CONCLUSIONS: Clinical experiences, in conjunction with literature evidence mentioned should help to clarify how to approach, evaluate, examine, and treat distal forearm fractures.