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Distal radius fracture surgery
Distal radius fracture surgery treats a break in the larger of the two forearm bones near the wrist, an injury commonly caused by a fall onto an outstretched hand. Surgery realigns the broken bone fragments and stabilises them, commonly with a plate and screws, to restore wrist alignment, function, and strength.
At a glance
Anaesthetic
General anaesthetic
Where
The Avenue Hospital
Day case or overnight
Day case or overnight stay depending on complexity, pain severity and other injuries
First post operative review
Approximately one week after surgery
Driving
Not until you have adequate wrist strength and control, generally after splint removal which is often six weeks after surgery
Post Operative Hand Therapy
Required after surgery to restore wrist and finger movement and grip strength
Splinting
Yes - a splint is worn for a period after surgery, even with plate fixation
Pain relief
Usually paracetamol and/or ibuprofen; stronger pain relief is commonly needed initially
Return to repetitive & heavy loading
Usually 6-8 weeks for return to full loading, guided by x-ray healing
Surgical fixation of a broken distal radius (wrist)
Distal radius fracture fixation is surgery to realign and stabilise a break at the end of the radius near the wrist, one of the most common fractures in the body. It is most often performed using a plate and screws applied to the volar (palm-side) surface of the bone.
Who is this procedure for?
- People with a displaced distal radius fracture that cannot be adequately realigned or held with a cast alone
- People with an intra-articular fracture (extending into the wrist joint) that is displaced
- People with significant shortening, angulation or comminution (multiple bone fragments) of the fracture
- Not needed for stable, minimally displaced fractures, which are usually treated with a cast alone
What does the surgery involve?
Surgery most commonly involves a volar (palm-side) approach, through which the fracture is realigned and a plate is applied to the bone with screws to hold it in the corrected position. Some fracture patterns are instead treated with closed reduction and percutaneous K-wires, or occasionally with an external fixator for particularly severe or comminuted fractures. The choice of technique depends on the fracture pattern, bone quality and your surgeon’s assessment.
Alternatives to surgery
Surgical fixation is one option for a distal radius fracture. Depending on your situation, the alternatives may include:
- Closed reduction and cast alone: appropriate for stable, minimally displaced fractures, or where surgery carries higher risk than benefit
- K-wire fixation: for some fracture patterns, avoiding a larger plate but still requiring a period in a cast
- External fixation: occasionally used for severely comminuted fractures or when soft tissue condition precludes internal fixation
What happens if left untreated: a displaced fracture left untreated is likely to heal in a shortened or angulated position (malunion), leading to reduced wrist movement, grip weakness, and an increased risk of arthritis, particularly with intra-articular fractures.
Dr Tomlinson will discuss which options suit your specific fracture at your consultation.
Frequently Asked Questions
Where will my surgery be done?
At the Avenue Hospital.
How much time will I need to have away from work?
This depends on what your job involves. If your work is desk-based, you may return within one to two weeks with the wrist splinted. If your work is physical or requires wrist loading, you’ll usually need 6-8 weeks or longer. Dr Tomlinson will give you advice tailored to your job and fracture at your consultation.
When will I be able to drive again?
Multiple things affect this: which hand was treated, whether you’re wearing a bandage, whether you can grip the wheel and respond safely in an emergency, whether you are driving for personal or commercial purposes, the nature of the vehicle you are driving, and your pain levels and medications. You also need to be safely in control of the vehicle for insurance purposes – you should be able to grip the steering wheel strongly with both hands and be able to take evasive action in an emergency before you get behind the wheel. As a guide: plan not to drive for six weeks after the procedure.
When can I do a full day of administrative or desk work?
Often from 2 weeks after surgery, particularly with some temporary adjustments (see below). Keeping your hand elevated and taking regular breaks helps reduce swelling and discomfort in the early days. If you need to drive to work or carry or lift objects as part of your administrative work then alternate or half days may be a prudent measure when first returning to work.
What workplace modifications might help?
Depending on your job, helpful temporary modifications can include:
– Half days or alternate days to begin with
– No heavy lifting
– Lighter duties or being off tools
– More frequent breaks
– Using a headset instead of holding a phone
– Voice-to-text or dictation instead of typing
– Keeping the hand elevated at your workstation
– Avoiding repetitive gripping
– Help with carrying or moving items
– Moving temporarily to reception or phone duties if your role is normally manual
– Protecting the wound if your work exposes your hands to water or contamination (e.g. food handling, healthcare, wet trades)
We’re happy to provide a letter for your employer outlining recommended modifications.
I take a GLP-1 medication (such as Ozempic, Wegovy, Mounjaro or Trulicity) — how does this affect my procedure?
GLP-1 medications, used for diabetes or weight management, slow the emptying of the stomach. This can increase the risk of stomach contents being present during sedation or a general anaesthetic. In line with current ANZCA guidance you’ll be asked to follow a clear-fluid-only diet for 24 hours before your procedure, followed by the standard 6-hour fast. Please tell us and your anaesthetist that you take this medication — your anaesthetist will give you specific instructions.
How long will I need to wear a splint?
A splint is typically worn for a period after surgery, even with plate fixation, to protect the wrist while soft tissues heal, though movement is usually encouraged earlier than with cast-only treatment.
Will I need to see a hand therapist afterwards? May I see one if I'd like?
Hand therapy is required after surgery to help restore wrist and finger range of motion and grip strength, both of which are typically reduced after a distal radius fracture and its treatment.
What pain medication will I need afterwards?
Usually simple pain relief – paracetamol and ibuprofen – plus stronger pain relief for a few days or a week is all that’s needed. We can always prescribe stronger painkillers or painkillers for a longer duration if you need them.
Risks & complications
General risks of hand surgery
- Bleeding and bruising; rarely, a collection of blood (haematoma) that may need draining
- Infection, which may require antibiotics or, rarely, further surgery
- Pain — usually temporary, occasionally persistent
- Swelling – common, and usually settles over weeks to months
- Scarring – scars are permanent and occasionally become thickened, raised or sensitive
- Allergic reaction to the local anaesthetic, antiseptic, dressings, tape or suture material
- Delayed or problematic wound healing
- Stiffness or reduced movement in the fingers, hand or wrist
- Injury to nerves, causing numbness, altered sensation or, rarely, a painful neuroma
- Injury to blood vessels (arteries)
- Injury to tendons
- Injury to bone (fracture)
- Failure to fully relieve your symptoms, or symptoms returning over time (recurrence)
- Complex regional pain syndrome (CRPS) – an uncommon but significant condition causing ongoing pain, stiffness and swelling
- Cold intolerance – the hand becoming more sensitive to cold, usually improving with time
- The need for further surgery
- Blood clots in the leg or lung (DVT/PE) – uncommon in hand surgery, with a slightly higher risk after a general anaesthetic or prolonged immobilisation
Specific risks of this surgery
- Irritation or, rarely, rupture of a tendon (most often the tendon to the thumb) running near the plate or screws
- Numbness or tingling from irritation of the median nerve, occasionally requiring a carpal tunnel release
- Malunion or delayed/nonunion of the fracture
- Stiffness of the wrist or fingers
- Prominent hardware that may need removal later
Anaesthetic
Your anaesthetist will discuss the specific risks of anaesthesia with you separately.
Recovery & rehabilitation
First 48 hours
Keep your hand elevated for 72 hours to reduce bleeding and post-operative swelling. Local anaesthetic lasts 6–24 hours (occasionally 1–3 days); your hand may have numb areas during this time.
First week
Keep the dressing dry and intact until your post-operative review. Listen to your hand and do not perform activities that cause discomfort. You should find that your hand function is better each day. The movement to work on in the first week is pronation/supination, which describes turning your palm up and your palm down with your elbow held at your side.
Second week
A splint protects the wrist while the surgical wound and fracture heal. Finger movement and wrist rotation (supination/pronation) is encouraged early to prevent stiffness, while wrist movement is guided by your surgeon and hand therapist.
6 weeks
Full grip strength may take several months to return. The scar will feel tight and firm. Massage assists with improving scar mobility and minimising scar firmness. Once your x-ray shows sufficient bone healing you will be permitted to wean out of your splint and progress to heavier activities.
3 months
The scar firmness will start to resolve after 3 months, and will take up to 12 months to settle.
Long term
Hardware is not routinely removed unless it causes irritation.
Want to know more about Distal Radius Fracture Fixation?
Contact us to schedule an appointment with Dr Tomlinson.
Fees and costs
You will receive a written financial quotation after your consultation, once your operation and any third-party requirements are confirmed. See our Fees and informed financial consent page for how our fees work, what your quotation includes, and the resources available to you.