Distal Radial Fractures Flashcards
Where do distal radial fractures occur?
Distal metaphysis of the radius with or without articulated surface involvement
What are the three most common types of distal radial fractures?
Colles’ fracture
Smith’s fracture
Barton’s fracture
What is the most common mechanisms of injury that leads to distal radial fractures?
FOOSH
What is Colles’ fracture?
Extra-articular fracture of the distal radius with dorsal angulation and dorsal displacement
Typically occurs as fragility fracture
FOOSH - forces wrist into supination
What is a Smiths fracture?
Extra-articulate fracture of the distal radius with volar angulation, with or without volar displacement.
Caused by falling backwards on FOOSH and forced pronation type injury
What is Bartons fracture?
Intra-articulate fracture of the distal radius with associated dislocation of the radio-carpal joint.
Described as volar(more common) or dorsal(less common) depending on whether the volar or dorsal rim of radius is involved
What are the risk factors of distal radial fractures?
Risk factors related to osteoporosis:
- Increasing age
- female gender
- early menopause
- smoking or alcohol excess
- prolonged steroid use
What is the name of the deformity seen in Colles fractures?
Dinner-fork deformity
What is important to do in suspected distal radial fractures?
Neurovascular examination
What are the differential diagnosis of distal radial fractures?
Forearm fractures (Monteggia/Galeazzi)
Carpal bone fractures
Tendinitis or tenosynovitis
Wrist dislocation
What investigation would you order for distal radial fractures?
X-ray of wrist - AP/lateral
CT/MRI - in more complex cases to allow planning for operative planning
What three measurement can you take in a distal radial/wrist x-ray?
Radial height <11mm
Radial inclination <22 degrees
Radial(volar) tilt >11 degrees
What is the management for distal radial fractures intially?
A to E
Closed reduction with sufficient traction and manipulation under anaesthetic. Can be performed under conscious sedation with haematoma block or Biers block.
Below elbow backslab cast - repeat x-ray in a week to check for displacement
After one healed then rehab and physio
When is surgical intervention indicated in distal radial fractures?
- Significantly displaced or unstable fractures
- Fractures with a intra-articular step of radiocarpal joint >2mm
What are the surgical options for distal radial fractures?
ORIF
K-wire fixation
