Distal radius fracture: causes, symptoms, conservative and surgical treatment

How to treat a radius fracture faster? Such a question is the one which patients and doctors of Ladisten Clinic face quite often. After all, a fracture of the wrist bone is a common injury. Statistics say that its occurrence reaches 16% among all fractures, and among the injuries of the forearm, it is the leading one (90%).

Diagnostics of distal radius fracture

The first diagnostics take place right on the spot, in the moment when a person is injured. Usually, the injury is hard not to notice. A characteristic crunch and terrible pain arise immediately, and a person understands that he or she has broken his or her arm.

But in order to get an accurate diagnosis, one still needs a doctor’s consultation. After all, wrist injuries are very different, so their treatment also differs from case to case.

Symptoms of distal radius fracture:

• crunch in the moment of falling or getting an injury;
• a person can’t flex the wrist immediately after the fracture of the radius, it is impossible to make a fist and take an object;
• swelling after 30-120 minutes;
• in case if the joints are affected, hemorrhage occurs and a hematoma is visible.

In some situations, pain is felt in the hand only during physical exertion and no other signs are shown. This is dangerous because the bones may not grow together properly. Then patients turn to Ladisten with a complaint that after a fracture of the radius, the arm is crooked.

X-ray is the method used to confirm the diagnosis. It also determines the severity of the injury, the presence of displacements, fragments, accurate localization. MRI and CT scans show whether joints and muscles are affected.

Types of distal radius fracture

Doctors distinguish two main types of radius fracture:

1. Colles’ fracture. Prevails in all cases. When falling, a person leans on a palm reflexively. If a fracture occurs, the bone fragments are shifted to the back side.
2. Smith’s fracture. Occurs less commonly. The exact opposite of Colles’ injury which is found in case of falling on a hand that is concave inward. Therefore, the fragment is shifted to the palm.

Both types are equally dangerous and have the risk of complications if they are not treated on time and correctly. Even if you do not see a fracture visually and there is just a slight feeling of pain in the hand, you should still consult a doctor after falling on your wrist.

Classification

For how long a hand will hurt after a fracture of the radius depends largely on its type. The fractures may be complicated and simple. Pain of a different nature occurs, joints and soft tissues may be affected, or you may not feel the problem at all.

There are 5 main types of radius fracture:

1. Open fracture. Skin is affected and damaged, bleeding occurs. There is a high risk of infection, urgent surgery to restore the limb is required. Additionally, the patient is checked for tetanus vaccination; if it was not done previously, he or she is vaccinated;
2. Comminuted fracture. A complex type that is healed for a long time and is difficult to recover. The name means that the bone is broken into several fragments – three or more. It is impossible to put the pieces together without surgical manipulations;
3. Displaced fracture. Displacement of fragments inside a broken limb is what complicates the situation. They can knit in the wrong position and extend the period of treatment. The limb is deformed and may remain in such state forever without treatment. If there is a fracture of the radius with displacement, rehabilitation is also complicated. The patient has to get used to the new position and shape of the bones;
4. Intra-articular fracture. The injury affects the wrist joint, it also needs to be restored;
5. Extra-articular fracture. This one is considered the simplest as it does not affect the joint, and can be treated easily if there are no fragments and displacements.

Most fractures of the wrist radius require surgery.

Causes

The main cause is a fall on an outstretched arm. This is the innate reflex triggered by human body when one loses his or her balance. While falling, people extend their hand as a support and protection of internal organs, face and head. But the protective mechanism does not always work, the radius does not withstand the force of impact, body weight and breaks.

Injury can happen to anyone at any age.

Risk group includes sportsmen, people over 50 years old, patients with diseases of bones and joints.

Treatment (conservative, surgical)

Two ways of treatment can be used:

1. Conservative. It is used in case of simple fractures, without fragments and displacements. Plaster cast is applied to the patient, and the bones of arm are knitted under it. Conservative treatment is sometimes used to put together the fragments and treat the displacement. The procedure may fail and the limb will deform over time. The whole process of treatment takes from 4 to 6 weeks plus the rehabilitation period.
2. Surgical. It is carried out under anesthesia by cutting the arm and restoring the anatomical structure of a bone. The fragments are fixed with special titanium plates and screws. Transosseous osteosynthesis according to the method of Dr. Ilizarov¹ is also carried out, when a special fixation apparatus is used to restore the arm. In Ladisten, surgery is carried out using the advanced correction method introduced by Dr. Veklich, without the need to use traumatic spokes. There is no need to wear plaster after the surgery, only an elbow bandage. Recovery is faster, and the patient returns to his usual way of life.

How long does it take for a radius fracture to heal?

How long it will take for a fracture of the radius without displacement to knit also depends on the patient. After surgery or casting, it is necessary to perform exercise therapy procedures. Simple gymnastics includes a set of exercises for the fingers which are performed while sitting at the table. Also creams, ointments, electrophoresis are used during recovery.

Consequences

Among the main pathologies after the injury, there are:

• improper knitting. It mainly occurs if the problem is not noticed and not treated;
• chronic pain in the area of the fracture;
• deformation of the limb and decrease of its functions: one can’t normally make a fist, bend his or her fingers or hand;
• the joint loses its stability, arthrosis may develop;
• inability to perform circular hand movements in the wrist.

In the most advanced situations, one arm becomes shorter than the other.

To avoid complications, you need to consult a doctor on time in order to make a diagnosis and undergo surgery. At Ladisten, both procedures are being carried out for more than 30 years with the help of internally developed modern equipment and highly qualified medical experts.

Sourses

¹B. V. Veklich. “Treatment of bone defects with controlled transosseous osteosynthesis in the light of understanding fractures and their consequences as an angiotraumatic problem” Orthopedics genius, no. 2, 1999, pp. 98-104.