Distal Radius Fracture Flashcards
What are the three most common eponymous distal radius fracture types
Colles’ fracture
Smith fracture
Bartons fracture
which is the most common distal radius fracture
Colles’ fracture - 90%
What is the pathophysiology of distal radius fracture
Most commonly due to FOOSH
Elderly are most common to get this fracture due to osteoporosis however it can also occur in children
Distal radius takes 80% of the axial load when landing on OSH
What is a colles fracture
Fracture with dorsal angulation and dorsal displacement
Occur when FOOSH occurs of dorsiflexed hand
what is a smiths fracture
Describes volar angulation
Occurs when FOOSH occurs on flexed wrists
What is the Barton’s fracture
Intra-articular fracture of the distal radius associated with dislocation of the radio carpal joint
what are the risk factors
Increasing age
Female gender
Early menopause - due to osteoporosis
Smoking/alcohol
Steroid use
What are the clinical features of distal radius fracture
Immediate pain +/- deformity
Sudden swelling
Can have neurovascular damage therefore weakness/paraesthesia
What should the neurological examination of the distal radius include
Median nerve : motor - abduction of thumb, sensory - radial surface of distal 2nd digit
Anterior interosseous nerve: opposition of the thumb and index finger ( okay sign )
Ulnar nerve: motor - adduction of the thumb (‘Froment’s Sign’); sensory – ulnar surface of the distal 5th digit
Radial nerve: motor – extension of IPJ of thumb; sensory – dorsal surface of 1st webspace
what are the differential diagnosis
Forearm fracture
Carpal bone fracture
Tendonitis/ tenosynovitis
Wrist dislocation
what investigations need to be carried out
X ray - AP, Lateral and oblique
How do you manage a patient with a distal radial fracture
Closed reduction
If stable and successful reduction:
- below-elbow backslab case ( x ray repeated after one week )
If unstable/ displaced fracture:
- surgical intervention: ORIF, K wire fixation, external fixation
Then physio
What are the complications of distal radial fractures
Malunion
Median nerve compression
OA
