Dr. David J. Bozentka answers your questions about wrist fractures, commonly known as a distal radius fracture.
Q: What is a distal radius fracture?
A: The radius is the forearm bone on the thumb side of your wrist. When you break the radius bone about an inch from the wrist it is considered a distal radius fracture. These are the most common fractures of the wrist and occur most often when you fall on an outstretched hand. You will notice pain, swelling, and sometimes a deformity after the injury. The fracture can range in severity from very mild (requiring a splint for treatment) to a more severe injury in which the bone is shifted out of position and might need surgery.
Q: What should I do if I believe that I have broken my wrist?
A: You should support your wrist with a splint, apply ice, and elevate it. You should have an evaluation by a hand surgeon as soon as possible. The hand surgeon will often obtain an x-ray and place you in a well-molded, supportive splint or cast. You may need to have the wrist placed in a better position; this is called “reducing” the fracture. You will be asked to follow-up with your hand surgeon.
Q: What studies are performed in treating a distal radius fracture?
A: X-rays are performed in all patients to evaluate the extent of the injury. A CT scan might be needed to better evaluate the number of fragments and displacement. X-rays might be repeated every week or few weeks if you are treated without surgery to determine if the fracture has shifted out of alignment. A final set of x-rays are also taken to confirm that the fracture has healed, which occurs at six weeks or longer after the injury. If you are over 50 years of age, whether you are a male or female, ask your doctor about an evaluation for osteoporosis. A DEXA scan is often performed in the workup in the evaluation.
Q: How are distal radius fractures treated?
A: The treatment of this fracture is individualized for each patient. Multiple factors are taken into consideration such as your age, activity level, occupation, and hand dominance. Factors related to the injury that are considered include the number of fragments, if the joint surface is involved, the quality of the bone, and other injuries you may have sustained. The goal is to have the broken wrist bone heal in a position that will allow you to perform all your desired activities. In many cases, the fracture is treated in a cast or splint for approximately six weeks. Alternatively, surgery may require placement of pins, plates and screws and occasionally a device outside the skin called an external fixator to hold the position of the bone while it is healing.
Q: What are some of the complications associated with distal radius fractures?
A: You can develop wrist stiffness and a deformity following this injury. In addition, wrist arthritis can develop if the fracture involves the wrist joint and it heals in poor alignment. Injuries that have a break in the skin are considered open fractures and have a higher risk of infection. A small percentage of patients will develop numbness and tingling soon after the injury which may be due to a nerve injury or carpal tunnel syndrome. Timely and appropriate treatment will limit the chances of developing these complications.
David J. Bozentka, MD, is the chief of Hand Surgery in the department of Orthopaedics at the Perelman School of Medicine at the University of Pennsylvania, and the chief of Orthopaedic Surgery at Penn Presbyterian Medical Center. Bozentka is Board-certified in Orthopaedic Surgery and has a Certificate of added Qualification in hand surgery. He specializes in the diagnosis and treatment of all conditions affecting the hand, wrist and elbow in patients of all ages. His research interests focus predominantly on distal radius fractures and trauma of the upper extremity.