They are often extra-articular, but some may extend into the joint, and when they do, it is important to recognize. Most distal radial fractures in adult patients are transverse metaphyseal fractures. This is especially true when there is a multi-part fracture with joint involvement. In some complex cases, additional cross-sectional imaging (usually CT) is required to accurately assess the fracture. Oblique, spiral, or comminuted configurationĭistal radioulnar joint ( Galeazzi fracture-dislocation)ĭiagnosis usually only requires a standard wrist x-ray series. However, it is more important to recognize what makes the fracture more severe: There are many radiological classification systems, e.g. Smith fracture: extraarticular fracture with volar angulationīarton fracture: intraarticular fracture involving radial rimĬhauffeur fracture: intraarticular fracture involving radial styloidĪnother type of distal radius fracture is the Lister's tubercle fracture. Traditionally, eponymous names were given to the common fracture types of the distal radius:Ĭolles fracture: extraarticular fracture with dorsal angulation They are best described in terms of their fracture type, location, displacement, and joint involvement. Fracture of the distal radius can occur with injuries that exert much less force, e.g. In the elderly, the bones tend to have a much lower bone density and are consequently much weaker. falling from a significant height, severe road traffic accident. Thus, distal radial fractures in younger patients require much greater force, e.g. In young adults, the long bones tend to be strong and the force required to break the bone is significant. Trauma is almost always the cause of distal radial fractures and is often the result of a fall onto an outstretched hand (FOOSH). If a fracture does occur, there is usually associated with dorsal angulation. When most people fall, they do not axially load the forearm but apply an oblique force longitudinally and dorsally. If this force is greater than the strength of the bone, a fracture occurs. Pathologyįorce applied longitudinally or obliquely to the hand and wrist is absorbed by the distal radius because it is the load-bearing bone in the forearm. There may be an associated deformity and in severe cases, distal neurovascular compromise. They are in pain and have a reduced range of motion. The majority of patients with a distal radial fracture present following a fall onto an outstretched hand.
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