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Distal Radius (Wrist) Fractures
Understanding fractures of the radius near the wrist, one of the most common broken bones, and how they are assessed and treated.
What is a Distal Radius (Wrist) Fracture?
A distal radius fracture is a break in the radius, the larger of the two forearm bones, at the end nearest the wrist. It is one of the most common fractures, occurring especially after a fall onto an outstretched hand. It affects people of all ages, from older adults with weaker bone (osteoporosis) to younger people after higher-energy injuries such as sport, cycling or motor accidents.
Distal Radius (Wrist) Fractures at a glance
What is it?
A break in the radius, the larger forearm bone, near where it meets the wrist
Common symptoms
Pain, swelling, bruising and often visible deformity of the wrist
Who it affects
Older adults after a fall, and younger people after higher-energy injuries such as sport or cycling
Is it serious?
Most heal well, but a significantly displaced or joint-involving fracture can cause stiffness or arthritis if not treated appropriately
Treatment options
Casting or splinting for stable fractures, or surgical fixation for displaced fractures
First step
An examination and x-ray to assess how displaced or complex the fracture is
Symptoms and how Distal Radius (Wrist) Fractures present
The main symptoms are pain, swelling, bruising and often a visible deformity of the wrist, along with difficulty moving the wrist or gripping with the hand.
The history of a fall onto the affected wrist or a similar impact injury is a significant pointer to the nature of the injury.
Causes and risk factors for Distal Radius (Wrist) Fractures
- A fall onto an outstretched hand
- Osteoporosis, which weakens bone
- Sporting injuries
- Cycling accidents
- Motor vehicle accidents
How are Distal Radius (Wrist) Fractures diagnosed?
Diagnosis is based on examination and an x-ray, which confirms the fracture and shows how displaced or complex it is. A CT scan is sometimes used for fractures that involve the joint surface, to plan treatment more precisely.
Treatment options for Distal Radius (Wrist) Fractures
Treatment depends on how displaced (moved out of position) the fractured fragments are and whether the break involves the joint surface.
Fractures that are minimally displaced and in a stable position are often treated in a cast or splint alone, with follow-up x-rays to check the position is maintained as swelling settles.
Fractures that are displaced usually need to be realigned, and many benefit from surgical fixation, typically with a plate and screws, to hold the bone in the correct position while it heals. Dr Tomlinson treats and fixes straightforward distal radius fractures. More complex fracture patterns, non-unions and malunions may be referred to a colleague with the appropriate subspecialty experience for that level of complexity.
When to see a hand surgeon about a Distal Radius (Wrist) Fracture
Any wrist injury with pain, swelling, deformity or difficulty moving the wrist after a fall should be assessed promptly, ideally with an x-ray. Once the x-ray is done, which can be via your general practitioner, an urgent care centre, or a hospital emergency department, you will potentially be referred to a hand surgeon by your treating doctor.
What to expect at your Distal Radius (Wrist) Fracture appointment
At your appointment, Dr Tomlinson will examine your wrist and x-ray imaging. Together you will discuss whether splinting or surgery is the right treatment, and the further steps involved. Generally you will be unable to lift or load with the affected wrist for at least six weeks after the fracture.
Frequently Asked Questions
What is a distal radius fracture?
A distal radius fracture is a break in the radius, the larger forearm bone, at the end nearest the wrist. It is one of the most common fractures, often occurring after a fall onto an outstretched hand, and affects people of all ages, from older adults with weaker bone (osteoporosis) to younger people after higher-energy injuries such as sport, cycling or motor accidents.
What causes it?
Common causes include a fall onto an outstretched hand, osteoporosis which weakens bone, sporting injuries, cycling accidents and motor vehicle accidents. The force applied to the bone was greater than the bone was able to tolerate without breaking.
What can I do myself?
If you have pain, swelling, bruising or deformity of the wrist after a fall, avoid using the hand, hold your hand elevated in a sling and with the wrist still, and arrange prompt assessment with an x-ray rather than waiting to see if it settles.
What can a hand therapist do?
Hand therapy can support recovery once the diagnosis is made, helping with splint fabrication, splint guidance and a graded return of wrist and hand movement.
What can a hand surgeon do?
Dr Tomlinson will examine your wrist x-rays, discuss you and your hand/wrist use, and provide her recommendations for further treatment.
What can I expect from treatment?
Fractures that are minimally displaced and stable are often treated in a cast or splint alone, with follow-up x-rays to check the position is maintained. Displaced fractures usually need to be realigned, and many benefit from surgical fixation with a plate and screws to hold the bone in position while it heals.
What happens if it's left untreated?
A significantly displaced or joint-involving fracture that is not treated appropriately can lead to stiffness or arthritis of the wrist.
Related conditions and treatments
Another common wrist fracture involves a different bone, see scaphoid fractures and non-union. Wrist osteoarthritis can develop after a wrist fracture, especially if alignment is imperfect.