Planning and Techniques for Surgical Treatment of Open Distal Radius and Forearm Fractures

Open distal radius and forearm fractures are common in orthopedic practice and require careful management, considering patient factors, injury severity, and timing of surgery. The primary goal is to prevent infection and achieve the best functional outcome. 

Timing of Surgery: Early surgical intervention is recommended for open fractures to minimize infection risk. This includes surgical debridement, irrigation, and antibiotics. However, in cases with severe soft tissue damage or polytrauma, immediate fixation may not be feasible. Temporary external fixation followed by delayed definitive fixation is often preferred. 

Surgical Strategies: 

1. Damage Control Orthopedics (DCO):  In polytrauma patients, DCO involves temporary stabilization to manage systemic issues before definitive fixation, reducing complications. 

2. Definitive Fixation: ORIF, external fixation, and percutaneous pinning are common techniques, chosen based on fracture complexity and patient condition. ORIF allows early mobilization, while external fixation is useful in cases of severe tissue injury. 

3. Soft Tissue Management: Early wound debridement and appropriate closure or flap coverage are essential for preventing complications. 

Postoperative Rehabilitation: Early mobilization and tailored physiotherapy are key to restoring function and preventing stiffness. 

In conclusion, managing open distal radius and forearm fractures requires individualized treatment, considering timing, surgical techniques, and soft tissue care. Advances in techniques continue to improve outcomes for these challenging injuries.