Distal Radius Fractures

What is a distal radius fracture?

Fractures of the distal radius are the most common upper extremity fracture.

They are commonly referred to as a Colle’s fracture or wrist fractures but the best terminology is distal radius fracture. The tip of the ulna, or ulnar styloid can be fracture as well. When being evaluated for a distal radius fractures it is important to look for other injures that may occur in the extremity. For example, some distal radius fractures are associated with scaphoid fractures that may change the treatment chosen.

How do distal radius fractures typically occur?

These fractures usually occur from a fall on on outstretched hand from high energy activities activities like skiing but can occur from activities like mountain biking and other sports activities. . Low energy injures can cause distal radius fractures as well such as a slip and fall on ice. When evaluating a patient for distal radius fractures, the mechanism is important to determine treatment. In low energy injuries, patients may need to be screened for osteoporosis.

Different types of distal radius fractures

When describing distal radius fractures, we talk about intraarticular and extra articular fractures.

1. Intra articular fractures involve the joint and the joint cartilage is damaged. They are more severe and can result in arthritis if the joint is not realigned.
2. We also talk about displacement, which is when a fracture is out of place. These fractures need to be reduced to minimize the risk of arthritis and deformity.
3. Distal radius fractures can also be described as open or compound fractures. This is when the bone comes through the skin and these are surgical emergencies because of the risk of infection.

Some fractures can result in ligament damage or nerve damage and these may need to be addressed at the time of surgery.

Simple fractures that are not displaced and in good alignment will not require surgery. These are often treated in a cast or splint for 6 weeks and most activities can be resumed in 6-8 weeks.

Diagnosing distal radius fractures

X-rays are performed to make the diagnosis of distal radius fracture. We occasionally perform MRI’s and CT scans to help understand the fracture better to determine if surgery is needed and if so, to help with planning surgery.

Nonsurgical Treatment of distal radius fractures

Nondisplaced distal radius fractures can be treated in a splint or cast. Displaced distal radius fractures that are reduced back into anatomic or near anatomic alignment can also be treated in a cast. The fracture may need to be followed carefully with serial X-rays to watch for signs of displacement that may lead to the need for surgery.  The decision to treat a fracture either operatively or nonoperatively is based on many factors that Dr. Sachar will discuss with you.

Surgically treating distal radius fractures

Fractures that are displaced, in multiple pieces, in the joint and compound fractures require surgery to realign and stabilize the fracture. This is done to minimize the risk of arthritis in the future and to allow for early activity and maximum function.

When performing surgery, many factors are considered. Dr. Kavi Sachar tell patients he brings  a toolbox into the operating room and uses whatever is necessary to align the fracture and stabilize it so patients can begin early motion and activity. This often involves a titanium plate and screws. Dr. Kavi Sachar helped design one of the first-generation plating systems and continues to consult with industry to constantly improve the plating systems used.

This hardware does not needs to come out but occasionally, if bothersome or if it irritates tendons or nerves,  it is removed through a minor procedure.

The advantage of surgical fixation of distal radius fractures is it allows for early movement and activity. Every fracture is different and more severe ones may need to be casted.

Recovering from distal radius fracture surgery

Therapy is started soon after surgery to allow for finger motion and things like typing but lifting is limited to daily activities until the fracture begins healing.

Most patients can resume normal activities within 8-12 weeks and this depends on many factors such as healing, swelling and how severe the break was. Some patients can resume sports activities sooner and Dr. Kavi Sachar will work with the patient to both maximize activity while protecting the fracture as it heals.

Our goal is to always regain as much function as possible and minimize the risk of arthritis.

Modern surgical techniques have allowed us to help patients regain excellent function and to resume the activities they enjoy.

Schedule a consultation

Board-certified and fellowship-trained hand surge Dr. Kavi Sachar is widely regarded as one the nations leading experts on distal radius fractures. Dr. Sachar has three office locations in Vail, Aspen and Frisco, Colorado. If you or a family member has suffered a distal radius fracture, contact Sachar today. Dr. Sachar is part of the world-renowned Steadman Clinic. Dr. Sachar and his team are here to help.