Distal Radius Fractures
The notes on this page are written as a source of information to both patients and health professionals. It is a general overview and its content should not be seen as direct medical advice. Further information regarding diagnosis and treatment specific to your condition can be made via a consultation with Dr Amaranath.
Anatomy of the radius
The radius is one of two bones in the forearm (the other is the ulna). The distal end of the radius articulates with the carpal bones of the hand to make up the wrist joint. It takes on most of the load across the wrist joint (70-80%) when weight bearing and is subdivided into two recessed fossa’s that allow articulation with the carpal bones (scaphoid and lunate).
What happens in a Distal Radius Fracture?
Fractures of the distal radius can extend into the joint (articular) or avoid the joint (extraarticular). Fractures that involve the joint require anatomical restoration to minimise the risk of post traumatic osteoarthritis in the future.
In the paediatric population distal radius fractures are often incomplete and extraarticular. They have a high chance of healing and remodelling without an open procedure and are commonly placed in a moulded plaster cast.
What are the common causes?
Most fractures are caused by a fall on an outstretched hand. They are more common in the paediatric and osteoporotic population and can be associated with injuries to the distal radioulnar joint, scaphoid and scapholunate ligament.
What are the preferred Investigations/Imaging?
Plain X-Ray of the wrist- This should include an Anterior/Posterior and Lateral views.
CT scan of the wrist - This is commonly used to further quantify and accurately diagnose the fracture lines through the distal radius (helps with identification of articular extension of the fracture line).
What are the treatment options?
Non-operative – This treatment may be reserved for undisplaced extraarticular fractures. It commonly involves placing the wrist in a short arm cast for a period of 4-6 weeks depending on the age of the patient.
Open Reduction and Internal Fixation (ORIF) – In patients that have displaced fracture fragments, intraarticular involvement or are highly active then ORIF would be suggested. This involves making a small incision over the distal aspect of the forearm, reducing the fracture fragments and holding them in place with a plate and screws. This will allow for better healing and faster rehabilitation.
What does the rehabilitation/recovery involve?
To find out more about rehabilitation and recovery after upper limb surgery please see our Rehabilitation Protocols here.
