Distal Radius Fractures
What is it?
A distal radius fracture is a break in the radius bone, one of the two bones of the forearm, at the level of the wrist. It is the most common fracture of the upper extremity. There are many different types of distal radius fractures, some fractures involve the joints of the wrist and can also include the ulna bone.
What causes it?
Like most fractures, trauma from events such as falls, accidents, car crashes cause distal radius fractures. Most occur from falls on an outstretched hand (FOOSH).
What are the symptoms?
Fractures can be accompanied by pain, deformity, and swelling.
How is it diagnosed?
A physical examination is important to evaluate the injury, assess for whether a fracture has broken the skin, assess the status of the nerves and blood vessels, and for associated conditions.
What is the treatment?
The treatment of distal radius fractures varies considerably depending on both patient-based and fracture-based factors. The age, activity level and the particular imaging characteristics of the fracture can all be important considerations. When fractures are initially encountered and widely displaced, meaning the bones are not in their normal or acceptable alignment, a reduction, or realignment, of the fracture is recommended, followed by splinting. This maneuver relieves pressure on nerves and blood vessels, helps with pain, and reduced soft tissue trauma. If subsequent alignment on xrays is felt to be adequate, the fracture may be treated without surgery. Some fractures may not require any reduction. Conservative treatment then proceeds with immobilization, typically in a cast. Depending on the fracture, return visits for follow up xrays spaced 1-2 weeks apart may be necessary to ensure that the fracture alignment is maintained during immobilization. When xrays show alignment that is inadequate, surgery is recommended. The goal of surgery is to restore acceptable alignment while providing the stability to allow early motion or rehabilitation. Hardware, typically a variety of plates and screws or pins, are inserted into the bone to hold the alignment. The fracture anatomy and surgeon experience typically determines the optimal fixation strategy to address the wrist fracture.
After surgery, the surgeon decides the appropriate time to start range of motion to optimize the patient’s recovery. Typically range of motion exercises are started after 1-2 weeks and splinting may continue for about 4-6 weeks. Fractures usually heal within 6 weeks, but the rehabilitation from a wrist fracture can often extend longer, continuing to improve for several months, to a year or longer.
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