Distal Radius Fracture

Orthopedics

Fracture of the distal radius, typically from FOOSH; Colles (dorsal angulation) most common.

Clinical features

  • Wrist pain, swelling
  • Dinner-fork deformity (Colles)
  • Inability to use hand

Examination

  • Neurovascular exam — median nerve, radial pulse
  • Skin integrity (open fx?)

Investigations

  • PA + lateral wrist X-ray
  • CT if intra-articular

Differential diagnosis

  • Scaphoid fracture
  • Carpal dislocation
  • Wrist sprain

Management

  • Closed reduction + below-elbow cast for stable extra-articular
  • ORIF (volar plate) if displaced, intra-articular, unstable
  • K-wires in children

Drug therapy

  • Paracetamol + ibuprofen
  • Codeine PRN
  • Tetanus booster if open

Complications

  • Malunion (dinner fork)
  • Median nerve injury / CTS
  • Extensor pollicis longus rupture
  • CRPS

Clinical pearls

  • Always check median nerve function pre/post-reduction

Educational — verify locally.

WardRound

WardRound

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