Acute pain management
Open fractures require immediate IV antibiotics and urgent surgical washout
Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
Consider risk for compartment syndrome
Unstable Fracture - Immediate ortho referral
>20 degrees angulation
Intra-articular involvement
Marked comminution
>2/3 displacement
5mm shortening of the radius
Stable Fracture
Use Procedural sedation or Hematoma block
Hang 10 lb weight with finger traps or otherwise provide longitudinal traction
Recreate the injury by extending wrist to 90 degrees while elbow is flexed
Pull distal segment back, up, and then out; use both thumbs to apply volar pressure
Immobilize wrist with sugar tong splint at 15 degrees of flexion, 20 degrees of ulnar deviation, and slight pronation 
Goals for post-reduction X rays: normal radius length, normal radial inclination of 15-30 degrees and volar tilt of 10-15 degrees
>20 degrees angulation
Intra-articular involvement
Marked comminution
>2/3 displacement
5mm shortening of the radius
Use Procedural sedation or Hematoma block
Hang 10 lb weight with finger traps or otherwise provide longitudinal traction
Recreate the injury by extending wrist to 90 degrees while elbow is flexed
Pull distal segment back, up, and then out; use both thumbs to apply volar pressure
Immobilize wrist with sugar tong splint at 15 degrees of flexion, 20 degrees of ulnar deviation, and slight pronation 
Goals for post-reduction X rays: normal radius length, normal radial inclination of 15-30 degrees and volar tilt of 10-15 degrees
Colles' fracture
Boxer's fracture
Smith's fracture
Barton's fracture
Jefferson fracture
Radial styloid fracture
Hangman's fracture
Distal radioulnar joint disruption