Fractures

Question 1

Distal radius fracture

Answer 1

Common
Mechanism is fall onto an outstretched hand in elderly females with underlying osteoporosis
Typically it is a distal radius fracture occurring about 1 inch proximal to the wrist joint with dorsal angulation of the fracture fragment - distal end of the ulna is sometimes involved
Management is usually conservative with reduction of the fracture under either a haematoma or Biers block and immobilisation in a cast
Potentially unstable injuries should be managed with surgical fixation. Factors favoring instability include; dorsal tilt of more than 20 degrees, comminuted fracture, injury to the ulnar styloid, intra articular disruption
Young patients - typically have a higher energy mechanism of injury so are usually managed surgically
Elderly - important to initiate treatment for osteoporosis