The distal radius is the part of the forearm bone just above the wrist joint. Fractures of the distal radius are common, especially among the elderly as the bone tends to fracture after a fall on an out-stretched hand. This fracture is also common in the young. This is due to the presence of the growth plate, which tends to be weaker than the surrounding bone. In these age-groups, the fracture usually does not involve the joint space and tends to be a simple break.
However, this bone can also be fractured as a result of a high impact trauma. In these case, the fracture tends to be more severe and often involves the joint.
For the simple fractures in the young and elderly, the fracture is usually reduced under anaethesia and immobilised in a cast for 4 to 6 weeks. The cast is removed on confirmation of fracture healing and physiotherapy is started to readictae the wrist and finger stiffness.
In the severe or unstable fractures, treatment in a cast commonly leads to loss of bony reduction (shifting of the bone fragments) after the swelling begins to recede. If left alone, these fractures heal in a poor position, which then leads to stiffness and severe deformity of the wrist joint.
It is recommended in these cases that the fracture be treated with surgical reduction and stabilissation.
The options for stabilisation are many: metal pins, wires, plate/screws or an external fixator, and the surgical technique depends on the type of facture pattern and experience of the treating surgeon.
With stable surgical fixation, wrist and finger movements are started early to reduce stiffness.