TechniquesManagement of Metadiaphyseal Proximal Radius FracturesDemetri, Leah MD*; Young, Charlotte BA†; Patterson, Joseph T. MD‡; Kandemir, Utku MD*; Morshed, Saam MD, PhD, MPH*; Immerman, Igor MD*; Lee, Nicolas H. MD, MS* Author Information *Department of Orthopaedic Surgery, University of California San Francisco †University of California San Francisco School of Medicine, San Francisco ‡Department of Orthopaedic Surgery, Keck School of Medicine at the University of Southern California, Los Angeles, CA Conflict of Interest and Source of Funding: J.T.P. reports research support from AOTrauma North America. I.I. reports stock or stock options in ROM3, payment for presenting or speaking for Skeletal Dynamics, and is a board or committee member American Society for Surgery of the Hand. N.H.L. is a board or committee member American Society for Surgery of the Hand. For the remaining authors none were declared. Address correspondence and reprint requests to Nicolas H. Lee, MD, MS, 1500 Owens Street, San Francisco, CA 94158. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: September 2021 - Volume 25 - Issue 3 - p 156-164 doi: 10.1097/BTH.0000000000000325 Buy Metrics Abstract Metadiaphyseal proximal radius fractures blur the distinction between the radial neck and radial shaft fractures. Operative management presents unique technical challenges both in terms of surgical approach and fixation method. We discuss relevant anatomy, safe surgical approach, and options and techniques for fracture fixation. We describe 6 patients who achieved satisfactory functional outcomes, even in cases of severe bone loss secondary to ballistic trauma. An extensile dorsal approach with exposure of the posterior interosseous nerve is recommended when normal soft tissue intervals have not already been extensively disrupted. Robust fixation can be achieved by contouring and repurposing a variety of plates such as a variety of mini fragment plates (2.4 mm T or Y-plates), flexible nails, or even distal radius plates. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.