Synopsis: 35 YO white male fell off his horse playing polo.

The patient underwent a closed reduction in the emergency room and was placed into fiberglass splints, dorsally and volarly (the fiberglass allows a better radiographic examination).

These are the xrays (PA, lateral) obtained after closed reduction.

The reduction allowed a better evaluation of the fracture characteristics.

(3) What would your first option be? If that does not work, what would your fallback option be?

My personal first option would be a volar plate. I think that there is a significant amount of bone attached to the subchondral bone (see the lateral). The plate will need to be long enough to span the metaphyseal and the distal shaft fractures. I would have both a fracture plating system in the room (possibility of single screws to fix specific fratures) and an external fixator.

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