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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