Instructional Course Lecture   |    
Fractures of the Distal Aspect of the Radius: Changes in Treatment Over the Past Two Decades
Paul M. Simic, MD; Andrew J. Weiland, MD
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Instructional Course Lecture, the American Academy of Orthopaedic Surgeons

Paul M. Simic, MD
Andrew J. Weiland, MD
Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021. E-mail address for A.J. Weiland: weilanda@hss.edu

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Wright Medical Technology). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2003 in Instructional Course Lectures , Volume 52. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m. - 5 p.m., Central time).

Look for these related articles in Instructional Course Lectures , Volume 52, which will be published by the American Academy of Orthopaedic Surgeons in March 2003:
• "Acute Injuries of the Distal Radioulnar Joint/Triangular Fibrocartilage Complex," by David Lichtman, MD, and Atul Joshi, MD, FRCS
• "Scaphoid Fractures: Current Treatment and Techniques," by William P. Cooney III, MD
• "Flexor Tendon Repair and Rehabilitation: State of the Art in 2002," by Martin I. Boyer, MD, FRCS(C), James W. Strickland, MD, Drew R. Engles, MD, Kavi Sacher, MD, and Fraser J. Leversedge, MD

J Bone Joint Surg Am, 2003 Mar 01;85(3):552-564
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Treatment of displaced fractures of the distal end of the radius has changed over the course of time. In the past, closed reduction with immobilization in a plaster cast was considered the treatment of choice. Dr. Abraham Colles, in reference to fractures of the distal aspect of the radius, stated: "One consolation only remains, that the limb will at some remote period again enjoy perfect freedom in all its motions, and be completely exempt from pain; the deformity, however, will remain undiminished throughout life." 1 In 1814, when Dr. Colles described the fracture, there was no anesthesia (1846), no aseptic surgery (1865), no radiography (1895), no electricity (1879), and James Madison was the fourth President of the United States. Other great physicians of this early period thought of fractures of the distal part of the radius as rather straightforward injuries with a relatively good prognosis despite the method of treatment. But, as with other great men and their perceptions, they could be wrong.
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