Distal radius fractures

Last updated: July 26, 2022

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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 [1]
  • Bimodal peak incidence [1]
    • 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.

Overview of forearm and wrist fractures
Mechanism of injury Location Diagnostic findings
Monteggia fracture
  • Extension fracture: fall onto an outstretched and pronated forearm
  • Direct high-energy trauma to the forearm
Galeazzi fracture
  • Radial shaft
Colles fracture
  • Extension fracture: fall onto an outstretched hand
Smith fracture
Barton fracture
  • Extension fracture: fall onto an outstretched hand
  • Radial avulsion and dorsal displacement of the radiocarpal segment

Reverse Barton fracture

  • Avulsion and volar displacement of the radiocarpal segment

Hutchinson fracture

  • Extension fracture: fall onto an outstretched hand
Die-punch fracture
  • Axial loading force applied against the distal radius
Scaphoid fracture
  • Extension fracture: fall onto an outstretched hand with a hyperextended and radially deviated wrist

The differential diagnoses listed here are not exhaustive.

The radius should be realigned to its normal position after fracture reduction.

We list the most important complications. The selection is not exhaustive.

  1. Nellans KW, Kowalski E, Chung KC. The Epidemiology of Distal Radius Fractures. Hand Clin. 2012; 28 (2): p.113-125. doi: 10.1016/j.hcl.2012.02.001 . | Open in Read by QxMD
  2. Meena S, Sharma P, Sambharia A, Dawar A. Fractures of distal radius: An overview. Journal of Family Medicine and Primary Care. 2014; 3 (4): p.325. doi: 10.4103/2249-4863.148101 . | Open in Read by QxMD

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