The most common fracture of the arm and hand is the distal radius. When we are about to fall, most of us will automatically try to protect ourselves with an outstretched arm, which frequently fractures from the force exerted on it. Usually, the larger bone (radius) fractures near the wrist. As with any fracture, this is more common in people with osteoporosis.
Fractures of the distal radius are categorized into several sub-categories:
- Colles Fracture - This is the most common type of fracture and results in a gross change in the appearance of the wrist, often called a "dinner fork" deformity, where the broken bone angles upward toward the back of the hand. The median nerve near the wrist may also be damaged causing carpal tunnel syndrome. Your doctor will recommend treatment ranging from a simple cast to surgery, depending on whether the bone can be repositioned correctly.
- Smith's Fracture - In this type of fracture, sometimes called a "reverse Colles fracture," the broken bone is angled downward toward the palm. Once again, your physician will need to check for damage to the median nerve and blood vessels of the area. As with a Colles fracture, you may require surgical fixation of the broken bone.
- Barton's Fracture - This is both a fracture and dislocation of the wrist. The broken radius and small bones of the wrist (carpals) become "jammed" upward toward the elbow. Treatment usually requires internal fixation to secure the fracture and dislocated bones.
Know More to Feel Better!
Physical and occupational therapy can help you regain strength, flexibility and function of the wrist after a distal radius fracture.
If the fracture is a simple one (only one fracture line and no crush injury to the bone), simple cast immobilization for six weeks should result in healing. If there are multiple fracture lines, you may require surgical treatment of the fracture with external and/or internal fixation as well as some type of bone graft using your own bone or artificial bone material.
All of these fractures must eventually be reduced (put back in place) and stabilized. You will need to give the fracture adequate time for complete healing to take place. Your physician may repeat X-rays during this time to assure that the bone is healing properly.
Once the bones have healed adequately, your physician may refer you to a physical or occupational therapist for rehabilitation, which will return movement, strength and function to the wrist. This can sometimes be difficult to achieve and you will need to be dedicated and compliant in following your doctor's instructions in order to produce the best outcome.