Distal Radius Fracture

Question 1

What are the 3 most common types of distal radius fracture?

Answer 1

Colles’ fracture
Smith’s fracture
Barton’s fracture

Question 2

Causes of distal radius fractures

Answer 2

FOOSH

Osteoporosis

Question 3

What is a Colles’ fracture?

Answer 3

Extra-articular fracture of distal radius with dorsal angulation and displacement

Also includes an avulsion fracture of the ulnar styloid

Question 4

What is a Smith’s fracture?

Answer 4

Extra-articular fracture of distal radius with volar angulation +/- volar displacement

Caused by landing on dorsal surface of wrist

Question 5

What is a Barton’s fracture?

Answer 5

Intra-articular fracture of the distal radius with associated dislocation of the radio-carpal joint.

Question 6

Risk factors for distal radius fractures

Answer 6

Osteoporosis

Increasing age
Female
Smoking
Prolonged steroid use

Question 7

Clinical features of distal radius fractures

Answer 7

Following episode of trauma

Immediate pain
+/- deformity
Swelling

Question 8

What neurological examinations need to be done in distal radius fractures?

Answer 8

Median nerve

• thumb abduction
• radial surface of index finger

Anterior interosseous nerve
- opposition of thumb + index finger

Ulnar nerve

• thumb adduction
• ulnar surface of little finger

Radial nerve

• extension of IPJ of thumb
• dorsal surface of 1st web space

Question 9

Investigations for suspected distal radius fracture

Answer 9

X-ray (diagnosis of distal radius fracture)

• radial height <11mm
• radial inclination <22 degrees
• radial (volar) tilt >11 degrees

Question 10

Management of radial wrist fractures

Answer 10

Closed reduction

Stabilise with cast

Surgical intervention - displaced/unstable fractures

• ORIF
• k-wire fixation