These are fractures that involve the distal segment of the radius, of the ulna or both simultaneously. These are the most frequent fractures but not so among the fractures treated by internal fixation. Altogether they represent the 5,67% of the total series of surgically treated fractures that have been reviewed.

Historically, these fractures have been treated by conservative methods for several reasons: their prevalence in the elder and in females (labor reasons), the possibility to attain acceptable reductions under local anesthesia and reasonable immobilizations with plaster (economical and hospitalization reasons) and the fact that reasonably acceptable results can be obtained in badly reduced fractures, even with evident external deformity (functional reasons).

The technique of Kapjandi (percutaneous Kirschner wires support) was an important contribution to the conservative treatment. In the last few years, especially in young patients, there is an increasing trend towards reconstructive surgery and fragment stabilization by internal fixation with small fragment implants, especially designed for this purpose. Lately, this technique is also combined with the use of external fixators that, along with their advantages, sometimes are responsible for serious complications.

When deciding on and planning the surgery on a fracture of this segment, one must be very concious that one is going to perform a difficult, long and risky surgical procedure, that may need the use of bone graft and that, in any case, requires master of the internal fixation techniques applied to the small fragments. It is because of all of these considerations along with the economic reasons, that we think that this kind of surgery will not be brought into the general use in the medium term, even though its results may be brilliant.