The radius is one of the two forearm bones and is located on the thumb side of the hand. The part of the radius which articulates with the carpal bones to form the wrist joint is called the distal end. When the radius breaks in this area, it is a distal radius fracture.
A distal radius fracture typically occurs at approximately an inch from the bone’s end. It can happen on its own or alongside a fracture to the distal ulna (the smaller forearm bone).
These features are classified as a Colles or Smith fracture depending on the angle at which the distal radius breaks.
Colles fracture occurs following direct impact to the palm of an outstretched hand. For instance, it may occur when you use your hand with open palms to support yourself on landing from a fall.
The side view of a wrist following a Colles fracture resembles a fork looking down. The wrist has a noticeable “bump” in it, comparable to the fork’s neck. This appearance is due to the fractured end of the distal radius moving up toward the back of the hand.
Smith fracture is the less common of the two types of wrist fractures. It can result from an impact to the back of the wrist, such as falling on a bent wrist. In this form of fracture, the distal end of the radius usually slips down toward the palm side. This generally results in a noticeable dip in the wrist where the radius’s longer portion terminates.
Intense pain is the most common symptom of a distal radius fracture. There is usually associated swelling which can be so severe that moving the injured hand or wrist becomes challenging or impossible. If there is nerve damage, you may experience a tingling feeling or numbness in the fingertips.
If you suspect you’ve broken your wrist, look for the following signs and symptoms:
Waiting until the next day to visit a doctor may be acceptable if the injury is not particularly painful and there is no deformity. In the meantime, you can use a splint to protect the wrist while managing the pain and swelling with an ice pack and elevation.
Go to the emergency department if the damage is severe, the hand is deformed, there is numbness or pale fingers.
The doctor will request hand and wrist radiological scans to confirm the diagnosis. The most popular and commonly used diagnostic imaging method is X-rays. X-rays can reveal if bones are actually broken and whether they are displaced fractures. They can also indicate how many fractured bones are present.
Treatment for broken bones in the wrist follows the same basic principle as other fractures, i.e., the damaged parts must be repositioned and kept from moving until they heal.
Many factors influence management, including the type of wrist fracture, your age and level of physical activity, and the surgeon’s personal preferences.
Sometimes, the people present with displaced fractures that can’t be repaired or straightened without a surgical incision (open reduction). An open wrist fracture will need surgical treatment as soon as possible. Surgical procedures may influence how you use the forearm or wrist in the future.
Surgeons have several alternatives for keeping the fractured bone in the proper position as the bone heals:
If the bones in the wrist fractured in a reasonable position, an orthopaedic surgeon may apply a plaster cast, which the patient must wear until the bone has healed completely.
Splint and cast: If the fractured bone pieces are out of position and might impede future arm or wrist usage, they will need to realign. This can be accomplished without a surgical incision, i.e., closed reduction. After the bone has been appropriately positioned, your doctor may stabilise it with a splint or cast. As the swelling goes down, casts are usually changed every 2 to 3 weeks.
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 may be recommended. 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. The many advantages include a less noticeable surgical scar, the titanium plate with the locking screws afford better stability and is especially indicated for patients with osteoporotic bones. The ulnar styloid if fractured at the base it is advisable to fix the fracture.
Intra-articular distal radius fracture
People with bone disorders, such as osteoporosis, are more prone to fracture their wrists in even minor falls. This condition causes the bones in the body to deteriorate and become thin and brittle, putting sufferers at risk of fractures.
Injuries of this kind might also be influenced by age. Distal radius fractures are more common in those over the age of sixty than in younger people. Weakened bones or another medical condition causes fractures in the elderly.
Poor diet, illegal drug use, and menopausal women can all decrease muscle mass, making them more susceptible to fractures.
Your doctor may take frequent x-rays to closely monitor the healing process, depending on the severity of the fracture. X-rays may be done at weekly intervals for three weeks and then at six weeks if the fracture was reduced or believed to be unstable.
Doctors usually remove casts at about six weeks of healing. Physical therapy is frequently started at this time to restore the damaged wrist joint to full-functionality.
Because there are so many distinct types of distal radius fractures and various treatment choices, each person’s recovery is unique. Consult your doctor for details on your rehabilitation plan and how to resume normal daily activities.
Complications involving the bone, joint, and soft tissue can follow a distal radius fracture. They include:
Distal radius can be associated with many late sequelae and these include wrist stiffness, shoulder stiffness and constant pain and swelling of the wrist. Cast immobilisation of the fracture can sometimes be inadequate and result in deformity. This is due to collapse of the distal radius following or after removing of the cast.
These distal radius fracture malunions with collapse of the distal radius with a prominent ulnar bone at the wrist, if sentimental, this will require surgical correction.
Clinical bone healing takes around 4-6 weeks for distal radius fractures. However, it can take longer in certain cases. Regaining mobility, strength, and function may take another 6-12 months. Many people find that they can resume most of their normal activities 3-4 months following a fractured wrist.
Wearing a cast or splint can help treat distal radius fractures successfully. However, patients may require surgery for severe fractures. Surgical treatment involves using metal plates, pins, and screws to maintain the broken bones in an appropriate position while they heal.
The pain of a distal radius fracture is immediate and quite severe. It is accompanied by increased sensitivity to the lightest contact and soft tissue swelling. Patients can expect to experience minimal pain by six months following the injury.
For immediate medical treatment, please contact our 24hr hand and wrist emergency hotline at +65 6535 8833.