- Clinical science
Distal radius fractures are a common fracture of the arm, with a bimodal peak incidence between the second and third decade and individuals above 65 years of age. The mechanism of injury may be due to low-energy falls, especially in women with osteoporosis, or high-energy trauma that occurs during sports or motor vehicle accidents. Clinical features include tender, soft tissue swelling with decreased range of motion at the wrist joint. The diagnosis is confirmed by x-ray. While closed reduction may be considered as conservative therapy, more severe fractures (e.g., unstable, intraarticular, or open fractures) require surgical therapy.
- Colles fracture: extension fracture; the distal fragment is usually radially and dorsally displaced
- Smith fracture: flexion fracture; the distal fragment is radially and ventrally displaced
- Barton fracture: extension fracture; involves radial avulsion and dorsal displacement of the radiocarpal segment
- Reverse barton fracture: flexion fracture; involves avulsion and volar displacement of the radiocarpal segment
- Hutchinson fracture: avulsion fracture of the radial styloid
- Physical examination: peripheral perfusion, motor function, and sensation
X-ray: anterior-posterior, lateral, and oblique view of the wrist (including the carpal bones)
- See r
- Boxer's fracture (fifth metacarpal neck): Often occurs from punching a hard surface.
The differential diagnoses listed here are not exhaustive.
- Closed reduction while applying longitudinal traction through the fingers
- Dorsal forearm splint/casting and post-reduction x-rays
- Cast removal after 6 weeks
- Open, significantly displaced, intra-articular, and/or unstable fractures
- Neurovascular damage
- Postoperative immobilization of the forearm and in a dorsal forearm splint
- See c.
We list the most important complications. The selection is not exhaustive.