This study concludes that incidence of distal end radius fracture plating had increased over a. The wrist is made up of eight small bones which connect with the two long forearm bones called the radius and ulna. There are many types of distal radius wrist fractures. Ulnar variance, or radioulnar length, can be calculated in a variety of ways, all of which yield similar results. The end of the distal radius typically shifts down toward the palm side in this type of fracture. Distal radius fractures are those which by definition occur about one inch from the end of the bone. Colles fracture specifically is defined as metaphyseal injury of cortico. Mar 03, 2017 fractures of distal end radius are classified on the basis of.
Distal radius fracture wrist fracture johns hopkins. We conclude with a series of questions the radiologist should address in the initial description of fracture involving the distal radius. This usually makes for a distinct drop in the wrist where the longer part of the radius ends. Distal radius fracture wrist fracture johns hopkins medicine.
Next to the radius is a smaller bone called the ulna. Distal radius fracture an overview sciencedirect topics. Do you want to use the redesigned ao sr like an app. Abraham colles is credited with description of the most common fracture pattern affecting distal end radius in 1814, and is classically named after him. Incongruity of distal ruj if after reduction and fixation of the radius. Distal radius fractures can be reset either with surgery open reduction or without it closed reduction. There is a risk of infection with an open fracture. Intraarticular fractures of the distal end of the radius in young adults. The distal end of the radius is defined as the area three centimetres proximal to the radiocarpal joint, where the radius interfaces with the lunate and scaphoid bone of the wrist. Distal radial fractures are a heterogeneous group of fractures that occur at the distal radius and are the dominant fracture type at the wrist. Surgical correction of malunited fractures of the distal radius. These injuries may result in fractures with metaphyseal comminution, and can, in some cases, cause extensive damage to the joint surface, fragmentation of the metaphysis. In older people, the most common cause is falling on.
Distal radius fractures scott wolfe md upper extremity surgeon. Therapy services patient information fractured distal radius. A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. W v v, v l introduction his booklet was developed to help you be er understand the treatment, risks and recovery you can expect due to a broken wrist. Ae, drawings show normal distal radius in lateral projection with dorsal surface to right a, colles fracture b, smith fracture c, dorsal barton fracture d, and volar barton fracture e. Fracture of the distal end of the radius is in nearly all cases due to a fall on the outstretched hand. Distal radius fractures often occur as a result of a fall on an outstretched hand. The most common cause of distal radius fracture is a fall onto an outstretched hand, from either slipping or. Hutchinson fracture, fracture of radial styloid, is not shown and is best seen on frontal or oblique view.
It may result from an impact to the back of the wrist, such as falling on a bent wrist. The end of the bone nearest the wrist is called the distal end. Presence or absence of intraarticular involvement 2. It occurs in middle aged and elderly women commonly.
One of the most common distal radius fractures is a colles fracture, in which the broken fragment of the radius tilts upward. Please fax initial evaluation and progress notes to 815. Surgical correction of malunited fractures of the distal. In our study, distal radial fracture was more common in the 3rd and 5th decade with an average of 46. Recovering from a distal radius fracture sportshealth. Fractures of distal end radius linkedin slideshare. Fractures of distal end radius are classified on the basis of. The ulna bone may also be broken in younger people, these fractures typically occur during sports or a motor vehicle collision.
A distal radius fracture almost always occurs about 1 inch from the end of the bone. When iruj unstable, a ligament repair is recommended. The overall complication rate of distal radius fractures ranges from 6% to 80% and has been associated with poor functional outcomes. Pins and plaster treatment of comminuted fractures of the distal end of the radius. Full clinical practice guideline pdf on the treatment of distal radius fractures appropriate use criteria appropriate use criteria auc provide treatment recommendations on a patientspecific level using evidence from aaos clinical practice guidelines, along with clinician expertise and experience. When a distal radius fracture occurs, it contributes to considerable disability, increased dependence for the injured patient and causes a major challenge for health care systems. An improved understanding of kinematics, bone quality, and muscle forces acting across the fracture has led to increased awareness. Palmardorsallunate facet requires cast for undisplaced and in displaced, an orif required. Jan 10, 2015 pathomechanism of posteriorly displaced fracture the usual cause is fall on the hyperextended wrist athe theory of compression impaction when is hyperextended proximal carpal bones come and impact dorsal aspect of radius and body weight is transmitted through long axis of radius to distal end and compression occur at dorsal aspect of.
In young people, for example, distal radius fractures are often caused by highenergy trauma that involves various combinations of bending, compression, impaction and shearing. When the fracture is angulated dorsally, the dorsal edge of the most distal part of the radius is seen proximally and the volar edge is seen distally on the pa view. Different modalities of distal end radius fracture treatment. There is a case for specialist assessments, likely by physiotherapist, with. Orif of intraarticular distal radius fracture with druj instability 26. An open fracture means a bone fragment has broken through the skin. Distal radius fracture orif rehabilitation protocol. A trend toward increased distal radius fracture open reduction and. Functional outcome of volar locking plate fixation in. Out of the total number of cases n412 for fracture distal end radius, 5012% cases were managed with cast, 9122%with percutaneous fixation with kwire, 98 with external fixature, 78. Therapeutic alternatives for distal radius fractures.
The scope of this discussion will be limited to the more common entities, such as pediatric forearm and distal radius fractures, and will not include articular fractures, plastic deformation, and fracturedislocations, such as monteggia lesions. Distal end of radius part ii evidence based jbjs 93a d number 8 d april 20, 2011, 776 1. Malunion is the most frequent complication of fracture distal radius. F, torrance, ca 90503, usa watsonjones pointed out that a fracture is a soft tissue injury that happens to involve the bone 1. These common fractures usually occur when significant force is applied to the distal radial metaphysis. Slutsky, md, frcsc, mojca herman, ma, otrl, cht 3475 torrance blvd.
Although a broken wrist can happen in any of these 10 bones, by far the most common bone to break is the radius. The mechanism of its production has in the past, and in particular during the 19th century, received considerable interest, reflected by numerous experiments on cadavers. Functional outcome of volar locking plate fixation in distal radius fracture p j m h s vol. Your digital gateway to expertise, education, and innovation. Fracture malunion has been shown to associate with altered morphometric. Wolfe with the wide array of treatment options now available, this is an exciting era for the treatment of fractures of the distal radius.
Distal radial fractures can be seen in any group of patients and there is a bimodal age and sex. Distal radius fractures in older versus younger patients. This is called a distal radius fracture by hand surgeons. Functional outcome of volar locking plate fixation in distal. Patients with a distal radius fracture generally present with a history of recent trauma with subsequent pain, swelling, ecchymosis, and often an obvious deformity of the. Distal radius fractures broken wrist orthoinfo aaos. Modality of treatment for the distal end radius fracture. During recovery, these pain management techniques can be used for patients. Specific qualitative and quantitative features of the distal radius fracture apparent on the radiograph are discussed. This fracture is, as described by its name, a fracture of the distal radius associated with a dislocation of the radiocarpal joint, either volar or dorsal. Effect of malunited fractured distal end of radius. An overview article pdf available in journal of family medicine and primary care 34.
The radius is the larger of the two bones of the forearm and is located radially. Complex distal radius fractures, such as a volarly displaced fracturedislocation of the distal radius a bartons fracture, or those fractures who have a concomitant open wound with soft tissue damage will usually require an open reduction and internal fixation orif of the fracture with a plate fig. Translation of lower end of the ulna more than 1 cm or gross rotational instability ossesous. Complications of distal radius fracture fixation may arise from the injury or method of treatment, as well as both.
The treatment of distal radius fractures summary of recommendations the following is a summary of the recommendations in the aaos clinical practice guideline, the treatment of distal radius fractures. Fishman, in kelley and firesteins textbook of rheumatology tenth edition, 2017. Symptoms include pain, bruising, and rapidonset swelling. Client centered approach to distal radius fracture management. Unfortunately, despite its ability to categorize virtually each variation of fracture, there is little interobserver agreement when the. Pdf pins and plaster treatment of comminuted fractures. It also occurs in young men with high velocity, injury. Distal radius fractures are one of the most common injuries encountered in orthopedic practice.
The break can occur in many different ways, however. In younger people, these fractures typically occur during sports or a motor vehicle collision. This article discusses the recovery process for both approaches, plus the pain management tactics that can be used for all patients. Colles fractures occur proximal to the distal radioulnar joint. A wrist fracture is a medical term for a broken wrist. Key words distal, radius, fracture, surgical, fixation. The bone that is usually broken is called the radius. Pathomechanism of posteriorly displaced fracture the usual cause is fall on the hyperextended wrist athe theory of compression impaction when is hyperextended proximal carpal bones come and impact dorsal aspect of radius and body weight is transmitted through long axis of radius to distal end and compression occur at dorsal aspect of. Distal radius fracture orif rehabilitation protocol kelly holtkamp, m. The scope of this guideline is specifically limited to acute distal radius fractures. Suggested operative fixation for fractures with postreduction radial shortening 3mm, dorsal tilt.