Distal Radius Fracture
The distal radius is the larger of the two bones in the forearm. Because a fracture of the distal radius usually occurs approximately 1 inch from its end, which is close to where it connects to the bones of the hand near the thumb, it is usually referred to as a "broken wrist." In the United States, distal radius fractures account for approximately 70 percent of all forearm fractures, and are typically the result of landing on a hand that has been extended to break a fall, or of a sports-related injury. In addition, the elderly and those who have osteoporosis are prone to distal radius fractures because of the fragility of their bones.
Signs of Distal Radius Fracture
Distal radius fractures can be intra-articular, extending into the wrist joint, or extra-articular, not involving the wrist joint. Intra-articular distal radius fractures are more difficult to treat than extra-articular ones. Symptoms of a distal radius fracture include the following:
- Immediate pain, particularly during wrist flexion
- Tenderness
- Swelling
- Bruising
- Crooked- or bent-looking wrist
To diagnose a distal radius fracture, a physical examination is performed and X-rays taken to see the severity and exact location of the break.
Treatment of a Distal Radius Fracture
Depending on the severity of the distal radius fracture, treatment varies. If the bones are in good alignment, a plaster cast may suffice. If the bones are out of alignment, they will need to be reset, either by a doctor's moving the broken bones by hand or during surgery. In both cases, a splint is worn for a few days until swelling goes away; at that point, a plaster cast is put on. The cast is usually removed within 6 weeks, and physical therapy to strengthen the wrist prescribed.
Surgery is required when a distal radius fracture cannot be repaired by placing the wrist in a cast alone. During surgery, the bones are aligned, and then held in place with plates or screws, metal pins, an external stabilizer or a combination thereof. A cast may also be used; if so, it is left in place for approximately 6 weeks. An open distal radius fracture, in which the bone protrudes through the skin, requires immediate (within 8 hours) surgery. After it has healed, physical therapy is required for either a closed or open fracture.