Anatomy
A distal radius fracture almost always occurs about 1 inch from the end of the bone. The break can occur in many different ways, however.
Other ways the distal radius can break include:
- Intra-articular fracture. A fracture that extends into the wrist joint. (“Articular” means “joint.”)
- Extra-articular fracture. A fracture that does not extend into the joint is called an extra-articular fracture.
- Open fracture. When a fractured bone breaks the skin, it is called an open fracture. These types of fractures require immediate medical attention because of the risk for infection.
- Comminuted fracture. When a bone is broken into more than two pieces, it is called a comminuted fracture.
Causes
The most common cause of a distal radius fracture is a FALL onto an outstretched arm.Osteoporosis (a disorder in which bones become very fragile and more likely to break) can make a relatively minor fall result 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 or a fall off a bike may generate enough force to break a wrist.
Symptoms
A broken wrist usually causes immediate pain, tenderness, bruising, and swelling. In many cases, the wrist hangs in an odd or bent way (deformity).
Treatments
Nonsurgical treatments- If the broken bone is in a good position, a cast may be applied until the bone heals.
If the position (alignment) of your bone is out of place and likely to limit the future use of your arm, it may be necessary to re-align the broken bone fragments
After the bone is properly aligned, a splint or cast may be placed on your arm. A splint is usually used for the first few days to allow for a small amount of normal swelling. A cast is usually added a few days to a week or so later, after the swelling goes down
The cast is removed about 6 weeks after the fracture happened. At that point, physical therapy is often started to help improve the motion and function of the injured wrist.
Surgical treatments-. Sometimes, the position of the bone is so much out of place that it cannot be corrected or kept corrected in a cast. This has the potential of interfering with the future functioning of your arm. In this case, surgery may be required.
Procedure. Surgery typically involves making an incision to directly access the broken bones to improve alignment (open reduction, ORIF).
Cast and Wound Care
In some cases, original casts will be replaced because swelling has gone down so much that the cast becomes loose. The last cast is usually removed after about 6 weeks.
During healing, casts and splints must be kept dry. A plastic bag over the arm while showering should help. If the cast does become wet, it will not dry very easily. A hair dryer on the cool setting may be helpful.
Most surgical incisions must be kept clean and dry for 5 days or until the sutures (stitches) are removed, whichever occurs later.
