Wrist Fracture (Distal Radius Fracture)

Distal radius fracture (broken wrist) is one of the most common fractures. Falling on an outstretched hand more frequently leads to wrist fracture than falling on a clenched fist. Symptoms of wrist fracture include pain, swelling, restriction of function and even visible deformity of the wrist, depending on the extent of the injury.

Diagnosis:

If a distal radius fracture is suspected, a conventional radiograph (X-ray) of the wrist will be obtained.

Treatment:

Stable fractures that do not involve the joint surfaces can be treated conservatively. The doctor may simply apply a plaster cast to immobilise the hand and forearm while the fracture heals. If the ends of the broken bone are not displaced too far out of position, the doctor can reduce them (reposition them in the correct position) under radiographic control. Fracture reduction is performed under regional anaesthesia or short anaesthesia, as appropriate. Once the ends of the broken bone have been aligned, a cast is applied to hold them in place while the fracture heals.
The cast is removed after about 6 weeks. A follow-up X-ray is then obtained to assess the progress of bone healing. If the fracture has healed, the cast can be left off and physiotherapy exercises started to restore wrist function. Surgical treatment is indicated if the joint surfaces have been damaged, if the fracture is extremely unstable, if nerves and blood vessels have been injured, or if conservative treatment attempts have failed. There are various surgical options available for immobilisation of these fractures (wires, screws, plates, external fixators). After surgery, the hand and forearm are put in a cast for a variable duration depending on the degree of stability achieved through surgery. Subsequently, physiotherapy is performed for restoration of normal wrist function.