Georgios Panagopoulos MD | Orthopaedic Surgeon
A distal radius fracture is a break in the continuity of the radius near the wrist joint. It involves the final part of the bone that participates in the formation of the radiocarpal joint and is crucial for:
- Wrist stability
- Wrist flexion & extension
- Wrist pronation & supination
Accurate anatomical reconstruction is critical, as even small deviations can lead to chronic dysfunction.
🔎 Key takeaways at a glance
- Distal radius fractures are the most common fracture of the upper limb.
- It is usually caused by a fall on an outstretched hand (FOOSH injury).
- Proper anatomical reconstruction is required to avoid stiffness and post-traumatic arthritis.
- Most wrist fractures are treated conservatively, without surgery.
- Surgical stabilization with a plate, when required, allows early mobilization of the wrist.
- Treatment is individualized, based on age, activity, and fracture morphology.
Table of contents
What's a distal radius fracture?
A distal radius fracture, or break, is primarily a fracture of the lower end of the radius. These are very common fractures, especially in women over 65 years of age with osteoporosis. It is the most common wrist fracture.
Fracture types
There are many types of wrist fractures. A dorsally displaced, extra-articular fracture of the distal radius is the most common type, and it is known as a Colles fracture. A volubly displaced fracture is often called a Smith's fracture. Intra-articular fractures are also common (ie, Barton's fractures).
Causes
The most common cause of a broken wrist is a fall on the outstretched hand. This is one of the most common fractures related to osteoporosis in people > 65 years of age, second in line after hip fractures. Wrist fractures also occur during sports that involve frequent falls, such as snowboarding or skating, as well as contact sports. They can be a consequence of car accidents, that can result in very comminuted and challenging fractures.
Depending on the position of the wrist at the time of injury, the resulting fractures may have the following characteristics:
- Dorsal displacement (Colles fracture)
- Volar displacement (Smith fracture)
- Intra-articular fractures
- High-energy fractures with comminution
Symptoms
Symptoms of a distal radius fracture may include:
- Severe pain after the injury
- Swelling and bruising of the wrist
- Obvious deformity of the wrist
- Numbness and tingling, if your nerve is bruised
In some cases there is a possibility of associated lesions:
- Triangular fibrocartilage complexTFCC)
- Scapholunate injury
- Median nerve injury or bruising (carpal tunnel syndrome)
Diagnosis
The doctor will take a detailed history and examine you carefully. An x-ray is usually sufficient to confirm the diagnosis. If your wrist is crooked, the doctor may attempt to set it straight under sedation. A repeat x-ray may be ordered to check if the reduction was successful, and your wrist is now in an acceptable position. You will be typically referred for further treatment to an orthopaedic surgeon. The surgeon may request a CT scan for preoperative planning.
Treatment
Most distal radius fractures can be treated conservatively, if an acceptable position is obtained after closed reduction. The wrist is then placed in a splint or cast, and the fracture is followed radiographically, until bone healing is appreciated.
The cast is usually maintained for a period of 4 weeks, after which a removable brace can be used instead for safety and support. After cast removal, the patient follows an individualised rehabilitation program, in order to regain dexterity and avoid stiffness.
Some wrist fractures, however, are considered unstable and require surgery. These include fractures with intra-articular involvement, open fractures, or fractures with residual or secondary displacement after closed reduction.
Anatomic reconstruction is paramount.
The American Academy of Orthopaedic Surgeons points out:
Restoring the normal slope, length, and articular surface of the radius is a key factor in avoiding post-traumatic arthritis.
Even small loss of length or angular deformation can change the carpal loading.
The surgery is performed under general +/- regional anesthesia and involves the placement of a plate with screws. In the vast majority of cases, a volar locking plate is sufficient to control the fracture. In some cases, either the use of dorsal plates or the use of fragment specific fixation is required. Other methods of fixation are performed less frequently (external fixation or spanning plates, k-wiring, etc.). After surgery, immediate mobilization is usually encouraged to avoid stiffness. The surgeon will want to monitor you with repeated X-rays until the fracture heals.
Dr Panagopoulos has extensive experience in the treatment of wrist fractures, and will discuss with you all options during your visit in our office.
Recovery
Early mobilization is crucial.
- Early gentle motion (immediately after surgery)
- Physiotherapy for 6-8 weeks
- Complete recovery in 3-6 months
⚠️ Early mobilization reduces the risk of:
- Stiffness
- CRPS (Sudeck's atrophy)
- Chronic pain
The National Institute for Health and Care Excellence points out:
Functional rehabilitation after a wrist fracture should begin as soon as possible, when stability allows.
Potential complications
- Wrist stiffness
- Malunion or nonunion
- Post-traumatic arthritis
- Tendon rupture
- Carpal tunnel syndrome
Correct surgical technique and anatomical reconstruction significantly reduce complications.
Current literature emphasizes that the likelihood of arthritis increases when articular step-off remains.
As stated in The Journal of Bone and Joint Surgery:
The quality of the initial reduction is the most important predictor of long-term functional outcome.
Why is it important to be treated by an expert upper limb surgeon?
The wrist is one of the most complex joints in the human body.
Surgical treatment requires:
- Complete understanding of the mechanics of the wrist
- Experience in microsurgical techniques
- Correct choice of implants
Specialization in shoulder-elbow-wrist surgery ensures an optimal functional outcome.
📌 Summary – What You Need to Know
A distal radius fracture is not just “a broken bone.” It is an injury that directly affects:
- Wrist biomechanics
- Grip strength
- Overall upper limb function
The international scientific community agrees that:
✔ Restoration of anatomy is crucial
✔ Stable fixation allows for better recovery
✔ Early mobilization reduces complications
🔑 Specialized treatment increases the chances of full functional recovery and reduces the risk of long-term problems.
FAQs - Frequently Asked Questions
What's a distal radius fracture, or broken wrist?
A broken wrist is a break or crack in one of the bones of your wrist. This is usually a distal radius fracture.
What causes a wrist fracture?
A wrist fracture commonly happens after an awkward fall on the outstretched hand.
What are the symptoms?
– Pain
– Swelling & bruising
– Obvious deformity
– Numbness & tingling
How is diagnosis made?
– History & clinical exam
– Xrays
– Αξονική τομογραφία
What's the treatment?
Most fractures are amenable to conservative management in a splint or cast. In more severe cases, you may need surgery.
Wrist fracture & casting duration
The cast is usually maintained for a period of 4 weeks, after which a removable brace can be used instead for safety and support.
How long does it take to heal?
Usually 6 weeks for bone healing, but full functional recovery may require 3–6 months.
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