Introduction
The radius is the most commonly fractured bone.
The radius is a one of the long forearm bones extending from the elbow to the wrist. The distal radius refers to part of the radius bone that is closest to the wrist.
These fractures occur when we try to break a fall with our hands – fall onto an outstretched hand. The fractures usually occur 1-2 cm from the end of the bone in the wrist.
Sometimes these fractures are called Colles Fractures as they were described by Dr Abraham Colles.
Distal radius fracturs can occur in kids and younger people as a result of sporting activity or accidents. In the elderly population (above 60 years), it can happen as a result of a fall. Here, the bone is more easily broken as it becomes weaker due to osteoporosis.
Causes
- Sports.
- Motor vehicle / bike accidents.
- Simple Falls.
Signs and symptoms
Diagnosis is based on symptoms, examination findings and scans.
- Deformity / Bent wrist.
- Pain.
- Swelling.
- Bruising.
- Tingling in the fingers.
Tests
X-ray
This will reveal the fracture and the amount of displacement (separation) of the bone fragments.
CT Scan
CT Scan may be used to better visualise more complex fractures and plan surgery.
Non-surgical treatment
Fractures with no separation of bone fragments can usually heal well without the need for surgery.
This is the case of for a lot of fracture in kids where there is not a large amount of deformity / bend in the bone.
The treatment for these patients includes:
Cast / Plaster
A plaster is used to keep the wrist still to allow the fracture to heal and settle the pain down when you have the injury. The plaster is usually changed after 1-2 weeks to a permanent cast. Plaster / cast combination is used for about 6 weeks.
Pain Killers / Anti-inflammatory Medications
These assist with pain only.
Ice
This will help with pain and swelling in first 2-3 days.
Follow up visits / x-rays
The bone fragments can move until the fracture heals. Follow up x-rays and visits are required to ensure that the fracture is healing well.
Physiotherapy
Physiotherapy may be required in some cases to return the wrist to normal strength and movement after fracture has healed.
Recovery and return to sport
Arm is kept in cast for a minimum of 6 weeks.
It may take up to 3 months before achieving normal strength and movement.
Risks of Non-surgical treatment
- Malunion. The fracture may heal in bent position.
- Non-union. Where the fracture doesn’t heal.
- Wrist stiffness.
- Wrist Arthritis.