Wrist fracture (distal radius fracture)

Wrist fracture (distal radius fracture)

Your forearm consists of two main bones, the radius and the ulna. The end of the radius bone closest to the wrist is call the distal radius and fractures to this area are incredibly common. The distal radius is actually one of the bones broken most frequently in the body and is the most commonly broken bone in the arm.

Distal radius: why is it so commonly fractured?

The distal radius comprises around 80 percent of the wrist joint surface making it extremely vulnerable to fracture. During a fall or accident the natural reaction is to outstretch your hand to soften the impact to prevent injury. However, this is precisely the action that results in a fracture to the distal radius, as it bears almost your full weight on impact with the ground.

Types of fractures to the distal radius
There are five main types of fractures that can occur in the distal radius and these vary in severity from minor, with little pain, to severe, with extreme pain.

  • The most common of the fracture types is a colles fracture, when the broken bone tilts upwards creating a visible deformity.
  • An intra-articular fracture extends into the wrist joint.
  • Extra-articular fractures do not extend into the wrist joint.
  • Open fractures are perhaps one of the most shocking to experience, as the broken bone protrudes through the skin. Due to the high-risk of infection, this type of fracture requires immediate medical attention.
  • Single bones broken into more than two pieces are referred to as a comminuted fractures.

It is always essential to correctly diagnose the fracture type in order to treat it effectively, as some fractures are more difficult to treat than others and each type will be treated in its own individual way.

Signs and symptoms of a distal radius fracture

Symptoms of a fracture to the distal radius are almost always instantly visible at the time of injury. The different types of fractures will vary slightly from minor to severe, but symptoms of more severe fractures are generally very similar:

  • Immediate pain
  • Swelling
  • Tenderness
  • Bruising
  • Loss of function
  • Visible deformity/limp wrist

Causes: how can a wrist fracture occur?

The most common cause of a distal radius fracture is a fall onto an outstretchedhand and often need manipulation/plaster cast or internal fixation with a small plate.

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.

Diagnostics: determining the extent of your injury?

Your specialist 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).

X-rays will help to make an accurate diagnosis and assess the severity of the injury, as well as any displacement of the fracture. In severe injuries that may involve the joint of carpal bones, a computerised tomography (CT) scan is often used to help plan the most effective treatment.