Distal Radius Fracture

Aetiology

  • Often occurs due to a fall on outstretched hand

Pathophysiology

Fracture patterns

  • Colles: fracture of distal radius with posterior displacement of distal fragment
  • Smith: fracture of distal radius with anterior displacement of distal fragment
  • Barton's: intra-articular fracture of the distal radius with dislocation of the radiocarpal joint
notion image
notion image

Clinical presentation

Symptoms

  • Wrist pain and swelling
  • Wrist deformity

Signs

  • Ecchymosis and swelling
  • Diffuse tenderness
  • Motion limited by pain

Investigations

  • X-ray - AP, lateral, oblique
  • CT - evaluate intra-articular involvement, indicated in surgical planning
  • MRI - indicated in evaluaton of soft tissue injury

Management

  • Conservative - cast
  • Operative - ORIF or MUA and K-wires or external fixation

Complications

  • Median nerve compression from stretch of the nerve or a bleed into the carpal tunnel can accompany a Colles fracture
  • Fractures of the distal radius that heal in a poor position (malunion) may result in impaired grip strength due to loss of extension