Distal radial fracture (summary)

Distal radial fractures are a relatively common group of injuries that usually occur following a fall. The commonest of these fractures is a transverse extra-articular fracture and where there is associated dorsal angulation, this is termed a Colles fracture.

Reference article

This is a summary article. For more information, you can read a more in-depth reference articles: distal radial fracture, Colles fracture.

Summary

• anatomy
  • normal radius
• epidemiology
  • bimodal age and sex distribution
  • younger males in high energy mechanisms
  • older females after simple falls
• presentation
  • fall onto an outstretched hand with pain and deformity
• pathophysiology
  • after FOOSH force transmitted through the wrist
  • a direct blow to the wrist may also result in a fracture 
• investigation
  • wrist series (AP and lateral)
• treatment
  • often treatment is conservative with immobilisation in a cast
  • if there is deformity and fracture angulation reduction is required
  • in some cases, internal fixation is needed

Radiographic features

Plain radiograph

• wrist series

The commonest fracture of the distal radius is a transverse extra-articular fracture which is usually seen as a transverse lucency across the distal radius in the region of the metaphysis.

If there is impaction, the fracture may be seen as a sclerotic line.

Transverse fractures may be angulated - dorsal angulation is commonest (a Colles fracture). There may be fracture extension into the joint which is important to pick up.