Open fractures require surgery within 8 hours of the injury.

INJURY
Distal Radius Fractures

ALSO KNOWN AS
Broken Wrist

ABOUT
The distal radius fracture is the most common broken bone in the arm. This injury occurs when the area near the wrist breaks, about 1 inch from the end of the bone. Your wrist can break in many different ways and it is important to find the distinction between the type of fracture because some are more challenging to treat than others. In a Colles fracture, the broken portion will tilt upward, Intra-articular fractures extend into the wrist joint, extra-articular fractures do not extend into the joint, open fractures break through the skin, and comminuted fractures are broken in more than two pieces.

COMMON INJURY
Typically a distal radius fracture is caused by a forceful fall into an outstretched arm or from an accident such as a car collision. However, some people who suffer from osteoporosis (fragile bones) will experience breaks from little force.

DIAGNOSIS
Symptoms include immediate pain, weakness, bruising, swelling and/or a mangled appearance at the injury. Urgent examination is required to avoid serious infection if a bone has broken through the skin, the injury is abnormal in appearance/deformed, or fingers are not pink. Otherwise, you can protect the injury with a splint, elevate it, and apply ice until you can be examined by a doctor. Your doctor will order X-rays to see what kind of break you have incurred.

NON SURGICAL TREATMENT
Broken bones must be positioned correctly and held in place until healed. Treatment depends on many factors like age and activity level along with your surgeons recommendation. In some cases a “reduction” will be needed, where the bone pieces are re-aligned without opening the skin. A cast or a splint will be worn for a matter of time and regular x-rays may be required to monitor the healing process. When the splint or cast is removed, physical therapy might be ordered to restore normal function and mobility to the wrist.

SURGICAL TREATMENT
Open fractures require surgery within 8 hours of the injury. The open area must be thoroughly cleaned to avoid infection and you will be given antibiotics. In other cases where the fracture isn’t open but is so out of place that it cannot be corrected without surgery, a cut is made across from the broken bone to do an open reduction (re-alignment). These pieces may need internal fixation with titanium or stainless steel pins, screws, plates. With surgical repairs the injury may need to be immobilized with an external fixture (frame outside of the arm) or a plain cast.

Distal Radius Fractures
(Left) An x-ray of a normal wrist. (Right) The white arrows point to a distal radius fracture.
Image courtesy of AAOS