Wrist Fracture (Distal Radius Fracture)
The distal radius is one of the most commonly fractured bones in the body - it's the bone that people have usually broken when they say they have a "broken wrist". Most commonly it is fractured from a fall onto an outstretched hand. The radius is one of the two bones of the forearm; the "distal" radius refers to the end portion of the radius bone.
Causes & Symptoms
The most common cause of a distal radius fracture is a fall onto an outstretched arm.
Osteoporosis, a disorder in which bones become very fragile, can mean that a relatively minor fall results in a broken wrist. Many distal radius fractures in people older than 60 years of age are caused by a fall from a standing position.
A broken wrist can happen even in healthy bones, if the force of the trauma is severe enough. For example, a car accident, a fall off a bike or activities like snowboarding may generate enough force to break a wrist. Good bone health remains an important prevention option. Wrist guards may also help to prevent some fractures, in sporting activities like snowboarding for example, but they will not prevent them all.
Your consultant will examine your wrist to evaluate the extent of your injury and help establish whether there may be the possibility of an associated ligament injury or carpal bone fracture (for example a scaphoid fracture).
Plain x-rays will help make the diagnosis and assess the severity of the injury and any displacement of the fracture. In severe injuries that may involve the joint of carpal bones a CT scan is often used to help plan the most effective treatment.
Many wrist fractures that are minimally or not displaced may be effectively treated in a plaster cast. The position of the fracture during healing, however, may need to be closely monitored with repeat x-rays at intervals to make sure that the fracture is healing appropriately in the correct position.
Sometimes, the position of the bone is so much out of place that it cannot be corrected or kept corrected in a cast. This has the potential of interfering with the future functioning of your arm. In this case, surgery may be required.
Depending on the fracture, there are a number of options for holding the bone in the correct position while it heals:
- Metal pins (usually stainless steel) combined with casting
- Plate and screw fixation
- External fixator (a stabilising frame outside the body that holds the bones in the proper position so they can heal)
- Any combination of these techniques
Distal Radius Fracture Recovery Time
If your fracture is treated in a cast, typically it remains in place for a period of six weeks. After it is removed, you will benefit from rehabilitation supervised by a hand therapist. Whilst the cast is on you will not be able to drive.
If your fracture is treated surgically, you will be seen by a hand therapist and will start early movement of your hand and wrist. You will not be able to drive until you can grip a steering wheel strongly, which may take up to six weeks or more. You may be able to return to office duties after one week, but in a restricted capacity, especially if your injured wrist is your dominant hand. You will not be able to perform heavy duties or lift items of any significant weight until six weeks after surgery. Surgery, however, will ensure that the fracture heals in a better position and may allow for earlier return of function.