Distal Radius Fracture Symptoms and Treatment

Distal Radius Fracture

In the human body, there are two bones in the forearm: Ulna and radius. The radius is located on the side of the thumb. The part of the radius which is connected to the joint of the wrist is known as the distal radius. When the radius breaks near the wrist, it is known as distal radius fracture.

Usually, this break occurs because of falling onto a flexed or outstretched hand. This fracture can occur due to a bike accident, car accident, a skiing accident or can result from any sports activity. A distal radius fracture may be isolated or may occur along with a fracture of the distal ulna, a forearm bone on the side of the small finger. These injuries are known as the distal radius and ulna fracture.

On the basis of the distal radius angle as it breaks, the fracture is classified in two categories:

1.Colles fracture: It may occur due to direct impact to the palm. In Colles fracture, the side view of a wrist seems like the shape of a fork facing down. A noticeable bump in the wrist looks like the neck of the fork. This condition occurs when the broken end of the distal radius shifts up in the direction of the back of the hand.

2. Smith fracture: This is not a common fracture. It may be the result of an impact to the back of the wrist. For e.g. falling on a bent wrist. In this type of fracture, the end of the distal radius shifts down toward the side of the palm in this type of fracture. These fractures generally make for a perceptible drop in the wrist where the longer part of the radius ends.

Symptoms of distal radius fracture

1.Sudden pain with tenderness on touching

2.Swelling around the wrist

3.Bruising

4.Deformity

Treatment for distal radius fracture

Treatment of the distal radius fracture is mainly determined by the various factors such as: displacement of fracture, comminution, associated injuries to the median nerve and ulna fracture, involvement of joint, hand dominance, activity level and occupation of patient.

Though application of splint is the immediate treatment for these fractures which can provide comfort and manage the pain. In case of displacement of fracture, it needs to be reduced before the application of splint. Fracture reduction is carried out under local anesthesia.

Non-surgical treatment

Splint can be used as a definitive treatment if the distal radius fracture is in a good position, until the healing of bone. Generally, a cast can be used for up to six weeks. Then a removable wrist splint is applied which provides support and comfort. After the removal of cast, physical therapy can be initiated to regain previous strength and proper wrist functioning.

If the fracture was reduced or considered to be unstable, X-rays should be taken first at three weeks and further at six weeks. If the fracture was not reduced and considered to be stable, x-rays are required hardly. A displaced fracture requires correction first. After anatomical alignment, a plaster splint or cast is used. The reduction is generally carried out with local anesthesia. Then the evaluation of the fracture is required to determine whether it needs surgical treatment or can be treated by applying a cast.

Surgical treatment for distal radius fractures

If the fracture is unstable or cannot be treated by applying a cast, then surgery is performed through an incision over the volar aspect of the patient’s wrist. This can allow complete access to the break. Then pieces are put together and held in place using one or more locking plates and screws which are made available by orthopedic implants manufacturers.

A second incision may be required in specific cases on the back side of the wrist in order to reestablish the anatomy. Locking Plates and screws are used for holding the pieces in place. Fixation with plates and screws cannot be possible in case of multiple bone pieces. In such conditions, an external fixator with or without additional wires can be used to secure the fracture.

A splint is placed for two weeks, post-surgery. At the first follow-up visit, the splint can be removed and replaced with a removable wrist splint which the patient has to wear for four weeks. Physical therapy can be started after this first follow-up visit so that wrist function and strength can be regained. Since early motion is essential for the achievement of best recovery after surgery so after the removal of splint, exercises should be done regularly as prescribed by the surgeon or the therapist.