Distal Radius Fractures
The radius and ulna are the two bones in your forearm. The distal radius is the end of the radius that makes up part of the wrist joint. This is a very common area of the upper extremity that is fractured. It usually occurs after a fall or motor-vehicle accident. It is common for young people in high energy accidents and older people with osteoporosis to have this. People will have pain and swelling at the wrist as well as bruising. This is identified by a doctor's physical exam and x-rays. Sometimes a wrist CT scan is obtained to help with surgical planning.
Treatment for distal radius fractures depends on the severity of the fracture. More severe fractures have multiple pieces that have been spread apart from the intact radius. If there is only one piece that hasn't been shifted from the radius, casting can be performed. If the piece has shifted (called displacement) the surgeon will try to re-align the piece (called reduction) in the emergency room. If the piece will stay reduced it is considered a stable fracture and can be treated with casting. Fractures with many pieces that are displaced do no heal well in a cast. Surgery for this fracture involves realigning the pieces and holding them securely with a plate and screws. After surgery patients are still splinted initially until the swelling from surgery has resolved. People with distal radius fractures that heal with malalignment are at greater risk for developing wrist arthritis.