Distal Radius Fractures
Introduction:
Fractures of the distal end of the radius occur after a trivial fall in the elderly. In the young patients, result from motor vehicle accidents or falls on an outstretched hand. They can be intra-articular (extending into the wrist joint) or extra-articular.
Symptoms
Swelling, pain and deformity at the wrist with the inability to move the wrist.
Treatment methods
The management of distal radius fractures is dependent on the nature of the fracture – extraarticular or intraarticular, degree of displacement of the fracture, presence of comminution at the fracture site, age, and daily activity level of the patient. Extraarticular fractures or minimally displaced intraarticular fractures, particularly in old age with relatively less daily activity level, can be managed conservatively after closed reduction. The non-surgical management involves applying an above-elbow slab that is converted into a cast after one week. This cast is usually kept in place for 5 to 6 weeks. The patient needs serial x-rays during follow-up to monitor for displacement.
Thirty-three years old lady with Extraarticular distal radius fracture treated with closed reduction and pinning. Fracture united in 4 months with good functional outcome.
The surgical management can be closed reduction and pinning in extra-articular fractures with displacement. In fractures with comminution or intraarticular fractures, open reduction and fixation with locking compression plates are the management of choice. The common problems after the management of distal radius fractures (be it surgical or non-surgical management) are stiffness of the wrist and fingers. However, fixation with plate and screws allows early mobilization of the joints. Other complications include injury to the neurovascular structures and chances of infection.
Forty-five years old gentleman with comminuted intraarticular distal radius fracture treated with volar and radial plating. Fracture united in 4 months with good functional outcome.
OUTCOME
