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Distal Radius Fractures

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Other Names

  • Distal Radius Fracture
  • Radius Fracture
  • Wrist Fracture

Background

  • Overall, most common orthopedic injury representing 15-20% of all adult fractures [1]
  • Defined as a fracture of the distal metaphysis or epiphysis with or without extension into the joint space.

Pathophysiology

  • Anatomy
  • Most commonly occurs due to a fall on outstretched hand (FOOSH)

Risk Factors

Differential Diagnosis

Distal Radius Fractures

Differential Diagnosis Wrist Pain

Clinical Features

  • General: Physical Exam Wrist
  • Tenderness, swelling, bruising at site of injury
  • Deformity may or may not be present

Evaluation

Distal spiral fracture of radius following MVC

Radiographs

CT Scan

  • Evaluate for intra-articular involvement, surgical planning

MRI

  • Evaluate for concurrent soft tissue injuries

Classification

  • Several classification systems exist, no consensus on superiority

Management

Nonoperative

  • Closed reduction to as anatomic as possible
  • Indications for nonoperative management
    • Extra-articular or stepoff < 2 mm
    • < 5 mm of radial shortening
    • Dorsal angulation < 5° or within 20° of contralateral distal radius

Operative

  • Radiographic findings indicating instability (pre-reduction radiographs best predictor of stability)[2]
    • Dorsal angulation > 5° or > 20° of contralateral distal radius
    • Volar or dorsal comminution
    • Displaced intra-articular fractures > 2mm
    • Radial shortening > 5mm
    • Associated ulnar fracture (associated ulnar styloid fractures do not require fixation)
    • Severe osteoporosis
  • Articular margin fractures (dorsal and volar Barton fractures)
  • Comminuted and displaced extra-articular fractures (Smith's fractures)
  • Die-punch fractures
  • Progressive loss of volar tilt and loss of radial length following closed reduction and casting

Complications

See Also

References

  1. ↑ Meena S, Sharma P, Sambharia AK, Dawar A. Fractures of distal radius: an overview. J Family Med Prim Care. 2014 Oct-Dec;3(4):325-32. doi: 10.4103/2249-4863.148101.
  2. ↑ https://www.orthobullets.com/trauma/1027/distal-radius-fractures
Created by:
John Kiel on 11 June 2019 14:17:58
Authors:
Last edited:
13 October 2022 21:38:16
Categories:
Trauma | Osteology | Wrist | Forearm | Upper Extremity | Fractures | Acute

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