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In this work a new and personal interpretation of the wrist’s fractures is presented based on the study of the phylogeny, embryology, anatomy and biomechanics of this area and based on this new interpretation we set up a new clasification (part I), that will help to understand the injury patterns of the different fractures (part II) and to define a new “strategy” for the treatment of the radial fractures (part III). The postaxial axis is in charge of the development of the upper limb. The carpus and the hand were always articulated to the ulna and in order to allow the supination movement to appear, a portion of the carpus needed to pass to the radius. The areas are described in the wrist’s region: ulnar (internal); central (middle) and radial (external); each one of them present different origins: evolutive, formative, constitutive and functional. Each area has biomechanical different role, from where it emerges different “patterns” of injury. These different patterns produce shifts and instabilities in the different areas that respond to the phylogeny origin of each one of the anatomical stabilizer. When a trauma is produced in the wrist, the strengths are distributed differently in the three areas of the wrist. In the external area, the bone (radius), “compression” strengths are produced and in the internal area, ligaments and ulnart styloid, “distraction” strengths act.

revista iberoamericana de cirugía de la mano

Nueva interpretación de los estabilizadores anatómicos en la fractura de muñeca. Parte I: Evolución de la región de la muñeca y nueva clasificación de las fracturas de radio