Distal Radius Fracture Fundamentals
A structured approach to distal radius fractures: alignment, stability, articular involvement, soft tissue and patient-specific decision-making.
Learning objectives
- Describe key radiographic features without relying on a single number.
- Recognise instability, articular displacement and associated injuries.
- Understand the goals of non-operative and operative management.
- Plan early rehabilitation around fracture stability and soft tissues.
Start with the injury and patient
Mechanism, bone quality, age, functional demand, hand dominance, comorbidity and associated injuries affect management. The same radiograph can lead to different discussions in different patients.
Describe the radiograph
Assess radial height, inclination, tilt, intra-articular step or gap, comminution, carpal alignment and distal radioulnar joint relationships. Compare with the opposite side only when clinically useful.
Look beyond the radius
Associated ulnar styloid injury, carpal injury, median nerve symptoms, open wounds and acute compartment concerns can alter urgency and treatment.
Non-operative management
Stable or acceptably reduced fractures can be treated with immobilisation and surveillance. Early repeat imaging may be needed when loss of reduction is a concern.
Operative goals
Fixation aims to restore a functional articular surface and alignment while permitting rehabilitation appropriate to stability. Volar plating is common but not the only method.
Rehabilitation
Finger motion, oedema control and shoulder/elbow movement begin early when safe. Wrist motion and strengthening progress according to fracture stability, fixation and healing.
Case checkpoint
A 67-year-old active patient presents after a fall with an intra-articular distal radius fracture and transient median-nerve tingling. Management requires more than measuring dorsal tilt: document nerve symptoms, articular displacement, comminution, stability and patient goals.
Self-assessment
Q1. Why should management not rely on one radiographic measurement?
Outcome and stability depend on multiple fracture features plus patient function, biology and associated injuries.
Q2. Which neurologic issue deserves specific attention?
Median nerve symptoms can occur with distal radius fractures and should be documented and monitored.
Q3. What is the purpose of early follow-up imaging in some non-operative cases?
To detect loss of reduction before the fracture consolidates.
Q4. Is volar plating the only operative option?
No. Fixation strategy depends on fracture pattern, soft tissues and surgeon judgement.
Q5. What can begin early even while the wrist is protected?
Finger motion, oedema control and motion of uninvolved joints are commonly encouraged when safe.
Finished this module?
Save completion on this device. This is a learning-progress marker only and is not an accredited CME credit.