Distal radius fractures

Georgios Panagopoulos MD | Orthopaedic Surgeon

What is a 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. A wrist fracture commonly happens after an awkward fall on the outstretched hand. It is important to treat a broken wrist promptly to prevent stiffness, pain and permanent deformity.

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.

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

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

As a rule of thumb, if your bones are in an acceptable position after the initial reset, you will be sent home in a splint. Further treatment depends on the pattern of the break. Most fractures are amenable to conservative management in a splint or cast. If that’s the case with your fracture, you will have to stay in the cast for 4-6 weeks and followed up with serial x-rays until your doctor is satisfied with the healing process. If your wrist is broken in many pieces, the bone pokes through the skin, it is not possible to get an acceptable position of the fracture in the cast, or if your fracture displaces while treated in a cast, then you may be a candidate for surgery.

Surgery is typically done under general anaesthetic +/- nerve block and involves the use of a plate and screws in most situations. After surgery, you may be placed in a removable brace or a splint. You will be encouraged to move your fingers, elbow and shoulder in order to avoid stiffness. Early mobilization of the wrist is also encouraged, unless the surgeon is worried about the fixation being tenuous. Your surgeon will follow up with serial x-rays until they are satisfied with bone healing.  

Dr Panagopoulos has extensive experience in the treatment of wrist fractures, and will discuss with you all options during your visit in our office.

FAQs - Frequently Asked Questions