Distal radius fractures are a common fracture of the arm, with a bimodal peak incidence between the second and third decade and individuals above 65 years of age. The mechanism of injury may be due to low-energy falls, especially in women with osteoporosis, or high-energy trauma that occurs during sports or motor vehicle accidents. Clinical features include tender, soft tissue swelling with decreased range of motion at the wrist joint. The diagnosis is confirmed by x-ray. While closed reduction may be considered as conservative therapy, more severe fractures (e.g., unstable, intraarticular, or open fractures) require surgical therapy.
- Overall incidence: 2.5% of all emergency department visits 
Bimodal peak incidence 
- 10–30 years of age; typically due to high-energy trauma in males
- > 65 years of age; typically due to low-energy trauma in women with osteoporosis
Epidemiological data refers to the US, unless otherwise specified.
- Colles fracture
- Smith fracture
- Barton fracture
- Reverse barton fracture
- Hutchinson fracture: avulsion fracture of the radial styloid
- See “.”
- Physical examination: peripheral perfusion, motor function, and sensation
X-ray: anterior-posterior, lateral, and oblique view of the wrist (including the carpal bones)
- See “.”
- Radial inclination: In the posteroanterior view of a normal wrist joint, a line that is drawn tangential to the radial styloid, connecting the ends of the distal radius, makes a 30º angle with a line drawn perpendicular to the long axis of the radius (see diagram below).
- Volar inclination: In the lateral view of a normal wrist joint, a line that is drawn parallel to the articular surface of the distal radius makes a 10° angle with a line drawn perpendicular to the long axis of the radius.
|Overview of forearm and wrist fractures|
|Mechanism of injury||Location||Diagnostic findings|
|Galeazzi fracture|| |
|Colles fracture|| || |
|Barton fracture|| || |
Reverse Barton fracture
| || |
|Die-punch fracture|| |
|Scaphoid fracture|| |
The differential diagnoses listed here are not exhaustive.
- Conservative therapy
- Open, significantly displaced, intra-articular, and/or unstable fractures
- Neurovascular damage
- Postoperative immobilization of the forearm and in a dorsal forearm splint
The radius should be realigned to its normal position after fracture reduction.
- See “Complications of fractures.”
We list the most important complications. The selection is not exhaustive.