Distal Radius Fractures
The distal radius is the bone that very near the wrist. The end of the bone articulates with wrist bones and this constitutes the first half of the wrist joint. It is very common to sustain a fracture of
the distal radius following a fall on an outstretched hand. These distal radius fractures are more common in the elderly as they are more prone to a fall on an outstretched hand.
Diagnosis and Differentials of Distal Radius Fractures
Patients usually present with a history of a fall on an outstretched hand. There is usually deformity and swelling.
The pain is usually at the site of the fracture. The wrist fracture is easily picked up with a normal x-rays of the distal radius or the wrist. In a distal radius fracture that involves the joint your doctor may ask for a CT scan to further understand the degree of involvement of the wrist joint.
Management of Distal Radius Fractures
Conservative treatment of distal radius fracture includes plaster cast immobilisation of the forearm leaving the elbow free. Sometimes in a fracture that involved the ulnar styloid and the distal radial ulnar joint, immobilisation can be above the elbow to prevent supination and pronation of the forearm.
In cases where conservative management is not suitable surgical fixation is required. The most common approach to fixation of the distal radius now is through the volar aspect of the wrist. This requires the use of the anatomical volar locking plate. It confers many advantages in the the surgical scar is better hidden, the titanium plate with the locking screws afford better stability and is especially indicated for patients with osteoporotic bones.
Distal radius can be associated with many late sequalae and these include wrist stiffness, shoulder stiffness and constant pain and swelling of the wrist. Sometime the recurrence of the deformity can occur especially when the distal radius bone collapsed after removal of the cast immobilisation.