The radius is one of the long forearm bones ( the other one is the ulnar bone) that connects the elbow to the wrist. A distal radius fracture is a break in this bone just before the wrist joint.
The radius is the most frequently broken bone in the arm. A distal radius fracture is considered simple if the bone breaks in only one place.
- A complex distal radius fracture occurs if :
- The bone shatters into many pieces
- Other bones break along with the radius
- Parts of the broken radius move out of their normal position (called a displaced fracture).
A distal radius fracture is usually caused by a fall on an outstretched hand (called a FOOSH) or through contact sports and physical activities. A number of risk factors, such as low bone density or osteoporosis, may make it more likely for a distal radius fracture to occur. Women aged over 50 have an increased risk of a distal radius fracture.
A fractured distal radius may cause pain, swelling, bruising and tenderness and, in some cases, the wrist may look abnormal. Other symptoms can include numbness and tingling in the fingers (caused by compression on, or damage to, the nerves), or the inability to bend or straighten the fingers or thumb.
You should go to A&E if you suspect a fracture to the distal radius as even small hairline fractures can cause complications, especially if it involves the cartilage which cushions it against other wrist bones. Cartilage damage can cause quite substantial
pain in the wrist and in some cases can lead to osteoarthritis from wear and tear.
Examination and x-rays are needed so that your doctor can tell if there is a fracture and to help determine the treatment. Sometimes a CT scan or MRI may be used to get better detail of the fracture fragments and associated injuries.
In addition to the injury to the bone, ligaments (the structures that hold the bones together), tendons, muscles, and nerves may also have been injured when the wrist is broken.
These injuries may need to be treated in addition to the fracture.
In rare cases healing and rehabilitation afterwards is slowed down by the development of another condition called
Chronic regional pain syndrome (CRPS). This will need specialised treatment until the condition settles.
The type of fracture will determine the type of treatment.
Your hand or orthopaedic surgeon will decide which treatment is the most appropriate in your individual case.
Other important considerations include your age, overall health, hand dominance, work and leisure activities, the presence of any prior injury or arthritis, and any associated injuries.
A splint or cast may be used to treat a fracture that is not displaced, or to protect a fracture that has been set. Complex fractures may need surgery to properly set the bone and/or to stabilise it.
Fractures may be stabilised with pins, screws, plates, rods, or external fixation. External fixation is a method in which a metal frame outside the body is attached to pins which have been placed in the bone above and below the fracture site, in effect keeping it in traction with an external scaffold until the bone heals.
On occasion, bone may be missing or may be so severely crushed that there is a gap in the bone once it has been re-aligned. In such cases, a bone graft may be necessary. In this procedure, bone is taken from another part of the body to help fill in the defect. Bone from a bone bank or synthetic bone graft substitutes may also be used.
While the wrist fracture is healing, it is very important to keep the fingers flexible, provided that there are no other injuries that would require that the fingers be immobilised. If you have also had
tendon repairs you will need these carefully managed at the same time. Otherwise, the fingers will become stiff, hindering the recovery of hand function.
Once the wrist has enough stability, either by sufficient healing of the bone or with the help of plates and screws to stabilise them, it is safe to start gentle controlled exercises for the wrist and fingers with supervision from your therapist. It is also helpful to stretch and exercise the uninjured joints such as the elbow and shoulder as wearing a cast can be heavy for them and keeping the arm still can make them stiff and weak.
It is important to do the correct exercises and your Hand Kinetics Hand therapist can work with your hospital doctor to determine the appropriate timing for these exercises.
Hand Kinetics will work with you to help you to recover flexibility, strength, and function in your hand.
What kind of results can I expect? Recovery time varies considerably, depending on the severity of the injury, associated injuries, and other factors as noted previously. It is not unusual for maximal recovery from a wrist fracture to take several months.
Some patients may have residual stiffness or aching or swelling which can be helped with appropriate hand therapy and exercises on a regular basis to achieve the best results.
Please note:
If you have had arm or hand surgery please telephone to discuss this before attending. It is always helpful to bring any x-ray reports you may have if you recently attended hospital for your hand or arm condition.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
