Evolution of the views on the diagnosis and the treatment of the distal radius fractures (Part 1)

Fractures of the distal radius are common injuries that have plagued humanity throughout history. The first description of this injury appears in the writings of Hippocrates, who regarded it as a dislocation of the wrist. This view persisted for nearly 2,000 years. Subsequently, the works of Galen, Palladius, Celsus, Duvernay, and Fabricius detail the direction of hand displacement and the accompanying impairment of finger function. Numerous clinical observations, anatomical dissections, and experimental studies conducted by the greatest surgeons of the past have dispelled this misconception. The pioneering work in interpreting the true nature of the injury is generally associated primarily with the name of Abraham Colles, and the most common type of distal radius fracture bears his name. However, attempts at a correct definition had been made before him. For example, Jean-Louis Petit in the early 18^th century, wrote that some wrist dislocations were likely fractures of the distal radius. The French surgeon C. Pouteau was the first to conclude that this injury was not a dislocation, but a fracture. He pointed out a common misdiagnosis of these injuries. Undoubtedly, under the influence of representatives of the French school, fundamental changes occurred in medical science in the early 19^th century. G. Dupuitren and his contemporaries made significant contributions to understanding the true cause of distal radius fractures, their diagnosis, and treatment. The discovery of X-rays made it possible to appreciate the variety and complexity of these injuries. Although external immobilization was the most popular treatment for distal radius fractures for many centuries, improvements in internal fixation techniques in recent decades have allowed for significant advances in this field. This article provides a historical overview of the views on the diagnosis and treatment of patients with fractures of the distal radius from the time of the Ancient World until the discovery of X-rays.