Distal Radius Fracture

Fractures of the distal radius are common injuries of the wrist.  Distal radius fractures can occur after any trauma to the wrist, but are particularly common following a fall onto an outstretched hand.  

Anatomy and Causes

The radius is one of the two long bones of the forearm along with the ulna.  The radius forms joints with several other bones in the wrist allowing for the complex motion of the wrist and forearm.  Fractures of the distal, or “wrist-end” of the radius can disrupt the normal function of these joints.  Restoring the alignment of the distal radius with respect to these joints is essential to restore function after these injuries.

Symptoms and Associations

Distal radius fractures can span a broad range of severity.  Simple, low-energy fractures may only cause moderate discomfort and swelling, while more complex fractures can be associated with severe swelling, breaks in the skin, damage to nerves in the wrist, and other severe injuries.  

Treatment

The goal in treating distal radius fractures is to get the fracture to heal in an appropriate position.  While most distal radius fractures will heal without surgery, some fractures may heal in an incorrect position called malunion.  This can result in ongoing wrist pain, loss of range of motion, and poor function.

Non-operative

Fractures that are able to be held in good alignment in a cast or splint can often be treated non-surgically.  These are usually treated in a splint or cast for up to 8 weeks until fracture healing can be seen on x-ray.  Repeat x-rays are often needed early on to ensure that the fracture is healing in the correct position.

Operative

Fractures that cannot be held in a good position in a cast or splint may need surgery.  The most common surgery for distal radius fractures is termed open reduction and internal fixation, meaning that the fracture is put back into its correct position through an incision (open reduction) and then held in place with plates and screws (internal fixation).  This is most commonly done through a volar (palm-side) incision, though some fractures may require multiple incisions.  In very complex fractures, a temporary plate or external fixation device that