Wrist fracture (distal radius fracture)

Targeted treatment for wrist fractures

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 a Wrist fracture can 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.

Wrist fractures - Surgery only if necessary

Plaster cast

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.

Options for holding the bone in the correct position

Sometimes, the position of the bone is so much out of place that it cannot be corrected or remain 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 whilst e 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

Wrist Fracture: Aftercare & Rehab

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.

Wrist fracture: Our specialists

Our hand surgeons are highly experienced and expertly skilled leaders in all aspects of hand and wrist conditions. From the moment you begin your patient journey with us, you are treated as a partner in your care and your specialist will ensure you return to normal function, as soon as possible.

Mr Giuseppe Sforza

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Hand & Wrist

Consultant Orthopaedic Surgeon - Shoulder & Elbow

Consultant Orthopaedic Surgeon
MD MCh(Orth)
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Mr Ian Bacarese-Hamilton

Schoen Clinic Orthopaedic and Spinal Hospital London

Head of Department - International

Head of Department - Leg Lengthening

Consultant Orthopaedic Surgeon & Trauma Surgeon
FRCS(Orth)
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Mr Adrian Carlos

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Hand & Wrist

Consultant Orthopaedic Surgeon - Shoulder & Elbow

Consultant Orthopaedic Surgeon
MB ChB MSc(SurgSci) PgD(Orth) FRCS(Tr&Orth)
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Mr Livio Di Mascio

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Hand & Wrist

Consultant Orthopaedic Surgeon - Shoulder & Elbow

Consultant Orthopaedic Surgeon
MBBS FRCS Ed (Tr&Orth)
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Mr Dimitrios Karadaglis

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Hand & Wrist

Consultant Orthopaedic Surgeon - Shoulder & Elbow

Consultant Orthopaedic Surgeon
MRCS, MSc, Dip Orth, FRCS(Tr&Orth)
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Mr Ioannis Polyzois

Schoen Clinic Orthopaedic and Spinal Hospital London

Consultant Orthopaedic Surgeon - Hand & Wrist

Consultant Orthopaedic Surgeon - Shoulder & Elbow

Consultant Orthopaedic Surgeon
MB ChB MRCS CCSTOrth(Hons) FEBOT
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Wrist fracture: Our specialised hospital

Schoen Clinic Orthopaedic and Spinal Hospital London is at the forefront of treating conditions of the hand and wrist. With expert and rapid diagnosis, you benefit from a treatment plan that is tailored to you, ensuring you receive the best outcome.

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Authors, 09.06.2020