HAND/WRIST
Distal radial fractures are one of the most common fractures that occur in the upper extremity. These fractures are most common in females and occur in both young and older patents. In young patients, these injuries commonly occur because of high energy mechanisms such as sports or motor vehicle accidents and, in older patients usually from a slip and fall on an outstretched hand. In older patients, females are generally more at risk because of the higher incidence of osteoporosis and osteopenia.
Distal radius fractures often present with immediate pain, swelling, and bruising that occurs immediately after an injury. In some situations there may be a deformity of the wrist from the displacement of the bone. In all cases, patients should be evaluated and have X-rays obtained. On initial evaluation, it is important to check the swelling of the arm, evaluate for any deformity and perform a thorough nerve exam to rule out acute carpal tunnel syndrome or ulnar nerve symptoms. Based on this evaluation a treatment plan will be created by your provider.
Treatment of distal radius fractures can be nonoperative or operative depending on several factors including, fracture stability and fracture displacement, patient age, functional status as well as a patient's co-morbidities. In acute fractures, fracture reduction should be attempted to maintain acceptable alignment. If acceptable alignment is maintained then conservative management with splinting and casting is appropriate. If alignment does not meet these parameters then surgical intervention may be considered.
Surgical management of distal radius fractures typically consists of a same day surgery that is performed between 1 and 3 weeks after the original injury. Surgery typically consists of plate and screw fixation on the palm side of your wrist but can be done utilizing other techniques too. Following surgery, patients typically require early rehabilitation to regain range of motion of the hand and wrist. Following recovery of range of motion, strengthening of the wrist is then performed. Recovery after a wrist fracture can take several months and up to a year depending on the severity of the fracture.
