![]() In the next x-ray the radius fracture has healed (red oval) but has shortened. The right hand image shows that as the radius collapses and shortens it also angulates backwards. This causes the ulnar to impact against the carpal bones shown with the red circle. In this case, as the ulnar has not been fractured, it remains at it's normal length. The left hand image shows the radius collapsing in the line of the black arrow and becoming shortering in the process. The following x-rays demonstrate how the wrist can displace. Plaster of Paris is usually in place for four to six weeks. Only undisplaced simple fractures of the distal radius are treated non-operatively, in a plaster of Paris. Occasionally, fractures are investigated with CT scans, and these are particularly common with intra-articular fractures, to assess any step in the articular surface, which may pre-dispose to osteoarthritis. All these factors can suggest a more severe injury and more unstable fracture pattern. Many classifications have been identified, but important features of plain x-rays involve whether the fracture line extends into the joint surface (articular surface), whether the fracture is displaced (fracture fragments have moved), and whether, on the back of the wrist, the bone has crumbled (so-called dorsal comminution). These will often show the fracture pattern. Plain radiographs are the mainstay of investigations for distal radial fractures. ![]() Very quickly a patient will be placed in a temporary splint for comfort. Clinical examination by the doctor will include assessment of the sensation of the hand, to ensure no nerves have been injured, and assessment of the blood supply to the hand, to ensure no vessels have been injured, and also ensuring that all the fingers can straighten and bend, to ensure no tendons have been injured. ![]() Patients are in severe pain, with a restricted range of movement. Clinical examinationĪ distal radial fracture often is very easy to identify. When observed from the side-on, the wrist has a bump reminiscent of an upturned dinner fork. A common deformity of a Colles type fracture is the 'dinner fork' deformity. Patients will immediately notice severe pain in the affected wrist and may notice a deformity around the wrist. Patients who fall onto an outstretched wrist can heavily impact the radius, which may break. Who does it affect?ĭistal radial fractures can occur in any patient, but tend to be more common in those patients over the age of 50 and, in particular, those patients with osteoporosis. These include Colles fracture, Barton fracture, Smith's fracture and Chauffeur's fracture. Consultant Orthopaedic Hand Surgeon Other common namesĪ variety of fracture patterns around the wrist have been described, usually after the surgeon who first described the occurrence.
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