The distal radius is the bone that extremely near the wrist. The end of the bone articulates with wrist bones and this constitutes the first half of the wrist joint. It is quite common to sustain a fracture of the distal radius after 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 a slippery surface.
Patients usually present with a history of a fall on an outstretched hand. There is usually deformity and swelling. Sometimes the patient presents with pain and bruising around the wrist.
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.
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.
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.
If you would like to learn more about the treatment and the possible outcomes, feel free to inquire here.
Aftercare: Prevention of Complications