Distal Radius and Hand Fractures — Biomechanics, Fixation, and Functional Recovery

This episode reviews the core principles of distal radius, carpal, metacarpal, and phalangeal fractures, focusing on biomechanics, radiographic assessment, fixation strategy, and functional recovery.Topics include the three-column theory of the distal radius, classic fracture patterns such as Colles, Smith, Barton, chauffeur, and die-punch fractures, and key radiographic parameters including radial inclination, radial length, volar tilt, ulnar variance, and articular step-off. The episode also reviews volar locking plate fixation, the watershed line, and complications such as FPL rupture, EPL rupture, and acute carpal tunnel syndrome.Carpal and metacarpal injuries are discussed through high-yield patterns including scaphoid fractures, retrograde blood supply, AVN risk, snuffbox tenderness, Herbert screw fixation, boxer's fractures, the Jahss maneuver, rotational deformity, lag screw principles, and Bennett vs Rolando fractures.Phalangeal fracture management is reviewed through tendon-driven deformity patterns, including proximal and middle phalanx fractures, Seymour fractures, mallet fractures, PIP fracture-dislocations, dynamic external fixation, ligamentotaxis, and hemi-hamate arthroplasty. Additional pearls include intrinsic-plus splinting, K-wire principles, open fracture terminology, NSAID considerations, and the central hand trauma principle: restore length, fix rotation, and start motion early.Part of Dr. Lara’s Plastic Surgery Compendium — a high-yield audio reference for plastic surgery trainees and surgeons. Disclaimer:This podcast is intended for educational purposes only and is designed for medical students, residents, fellows, and practicing healthcare professionals. It is not intended to provide medical advice, diagnosis, or treatment for any individual patient. The content presented reflects general surgical principles and should not be used as a substitute for formal medical training, clinical judgment, or consultation with qualified healthcare professionals. Listening to this podcast does not establish a physician–patient relationship.SEO / Topic Keywordsdistal radius fracture, distal radius fixation, three column theory, Rikli Regazzoni, Colles fracture, Smith fracture, Barton fracture, chauffeur fracture, die-punch fracture, radial inclination, volar tilt, ulnar variance, volar locking plate, watershed line, FPL rupture, EPL rupture, acute carpal tunnel syndrome, scaphoid fracture, retrograde blood supply, scaphoid AVN, Herbert screw, boxer’s fracture, Jahss maneuver, rotational deformity, Bennett fracture, Rolando fracture, Seymour fracture, mallet fracture, PIP fracture dislocation, dynamic external fixation, ligamentotaxis, hemi-hamate arthroplasty, intrinsic plus splint