Distal radius fractures (broken wrist)

What is a distal radius fracture of the wrist?

Distal radius fractures occur when the radius - one of the two long bones in the forearm - breaks close to the wrist. This is the most common bone to break in the arm and can occur in many different ways to people of all ages. In younger people, distal radius fractures typically occur in high-energy accidents, whereas in older people, distal radius fractures can be due to a simple fall onto the wrist. There are many different types of distal radius fracture:

  • Colles fracture - occurs when the broken fragment of the radius tilts upwards, and is the most common type of distal radius fracture;

  • Smith fracture - occurs when the broken fragment of the radius tilts downwards

  • Intra-articular fracture - occurs when the fracture extends into the wrist joint;

  • Extra-articular fracture - when a fracture does not extend into the wrist joint;

  • Open fracture - occurs when the fractured bone breaks the skin;

  • Comminuted fracture - occurs when the radius bone is broken in more than two pieces.

Displaced fractures are when the fragments of the bone have moved or slipped from their original position and usually require surgical intervention. In contrast, non-displaced fractures can often be treated with a cast or splint.

How do I know if my wrist is broken?

There is usually pain and swelling/bruising of the wrist immediately after the injury has occurred, and in often the wrist hangs in an odd or bent way.

It is also possible for there to be numbness in the fingers if the the fracture has affected the nerve(s) to the hand. It is important to seek urgent medical advice for these distal radius fractures to avoid potential permanent nerve damage.

How Ben can help?

Diagnosing distal radius (wrist) fractures

Ben will first chat to you about how your injury happened and what symptoms you are feeling. He will then use two methods to diagnose your fracture:

  • Physical Examination: Ben will examine your wrist, ascertain where there is tenderness, and check for any less-obvious physical deformities that may have been missed by your GP and/or emergency physician. He will also look for swelling, bruising and/or loss of motion in your wrist and/or thumb.

  • Imaging tests: Ben will most likely order X-rays to determine if the radius is indeed fractured as well as if the bone fragment(s) is displaced. Computerised tomography (CT) scans may also be ordered if Ben wants a 3-D picture of the broken bone, which may aid in surgical planning.

Treating distal radius fractures

Non-surgical treatment

Non-surgical treatment is generally offered when the fractured bone is non-displaced, however in some cases, the radius can be straightened without undergoing surgery in a process known as ‘closed reduction’.

Once the radius bone is properly aligned, Ben will usually place your forearm in a cast or a splint that starts just above your elbow. The cast is often changed again 2-3 weeks later when the swelling has reduced.

Depending on the fracture, Ben may require multiple X-rays to be taken during the healing process to ensure bone alignment is maintained. You will usually have your cast removed 6 weeks after the injury.

It is common for the fracture to be stiff after it heals, due to the lack of use. As such, Ben will usually refer you to a hand therapist to improve your range of motion.

Surgical treatment

Ben will recommend surgery if the fractured bone cannot be manipulated into its correct position using the ‘closed reduction’ approach. The goal of surgery is to stabilise the fracture and ensure it is given the best chance to heal so you regain function of your wrist. This surgical process is known as an ‘open reduction’.

Ben will typically make a small incision on the wrist where the fracture is located. He will locate and protect important structures in the wrist including arteries, nerves and tendons, and then will realign the bones. He may need to use small pins, screws, plates and/or wires to hold the fractured bones together. Sometimes these devices will stay on or in your bone for life, but in other cases, they will need to be removed after the fracture heals.

A cast it usually placed on the arm after surgery and will need to remain there for at least 6 weeks. Ben will discuss with you your specific recovery timeline as part of your consult/s with him.

Hand therapy is usually always recommended to maximise the chance of regaining full range of motion and strength and returning to your pre-injury state should be expected to take up to 1 year. However, most patients will be able to resume light activities within 1-2 months after surgery.

  • Ben operates at multiple hospitals across Melbourne’s bayside and peninsula region, including:

    • Linacre Private Hospital, Hampton

    • Peninsula Private Hospital, Langwarrin

    • The Bays Private Hospital, Mornington

    He can discuss your preferences in person during your consultation.

  • Ben will see you for a post-operative appointment usually 2 weeks after your surgery. During this appointment he will asses your wound and check that healing and mobility is progressing as expected. There will be no cost for this appointment.

    As well as this, Ben will usually refer you to a hand therapist, who focuses on rehabilitation after an injury, and will work with you to improve function of the affected area.

  • You can usually start driving again 4-6 weeks after the operation. However, every surgery is different, so Ben will provide individualised advice as part of the initial consultation.