Radius Fracture – Causes, Symptoms and Treatment
A radius fracture is a break in the radius, one of the two bones of the forearm. It is one of the most common fractures and typically occurs after a fall onto an outstretched hand.
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A radius fracture is a break in the radius, one of the two bones of the forearm. It is one of the most common fractures and typically occurs after a fall onto an outstretched hand.
What Is a Radius Fracture?
A radius fracture is a break in the radius, one of the two bones of the forearm. The radius runs along the thumb side of the forearm and plays a key role in the movement of both the wrist and elbow. Radius fractures are among the most common fractures seen in emergency medicine, affecting older adults, children, and physically active individuals alike.
Causes
The most frequent cause of a radius fracture is a fall onto an outstretched hand (known as the FOOSH mechanism). Other causes include:
- Direct trauma to the forearm, such as in traffic accidents or contact sports
- Osteoporosis: Reduced bone density significantly increases fracture risk, particularly in postmenopausal women
- Stress fractures from repetitive loading in athletes
- Pathological fractures due to bone disease or tumors
Types of Radius Fracture
Radius fractures are classified by location and the mechanism of injury:
- Distal radius fracture: A break near the wrist end of the radius – the most common type
- Colles fracture: A distal radius fracture with dorsal (backward) displacement of the fragment, typically after falling on an outstretched hand
- Smith fracture: A distal radius fracture with volar (forward) displacement of the fragment
- Radial head fracture: A break near the elbow end of the radius
- Radial shaft fracture: A break through the middle portion of the bone
Symptoms
Typical signs of a radius fracture include:
- Severe pain around the wrist, forearm, or elbow
- Swelling and bruising at the site of injury
- Restricted movement of the wrist or arm
- Visible deformity of the wrist (e.g., the classic dinner fork deformity in a Colles fracture)
- Numbness or tingling in the fingers or hand if nerves are involved
Diagnosis
A radius fracture is diagnosed using the following methods:
- Clinical examination: Palpation of the bone, assessment of range of motion, and neurological testing
- X-ray: The standard method for visualizing the fracture in two planes
- CT scan: Used for complex or intra-articular fractures requiring detailed evaluation
- MRI: Indicated when ligament or tendon injuries are suspected alongside the fracture
Treatment
Conservative Management
Non-displaced or stable fractures are often managed without surgery:
- Cast immobilization: A plaster or fiberglass cast is applied to the forearm and wrist for approximately 4–6 weeks
- Elevation of the arm and ice application to reduce swelling
- Pain relief with analgesics such as ibuprofen or paracetamol
Surgical Treatment
Displaced, unstable, or intra-articular fractures typically require surgical intervention:
- Volar plate fixation (ORIF): Internal stabilization using a metal plate and screws – the most common surgical approach
- Kirschner wire fixation: Minimally invasive stabilization using thin metal wires, often used in children
- External fixator: An external frame of pins and rods used for severely comminuted fractures
Rehabilitation
Following immobilization or surgery, physiotherapy is essential to restore range of motion, strength, and coordination in the wrist and arm. Full recovery can take anywhere from 6 weeks to several months depending on the severity of the fracture.
Complications
Potential complications of a radius fracture include:
- Malunion with lasting functional impairment of the hand and wrist
- Nerve injury, particularly to the median nerve, leading to carpal tunnel syndrome
- Tendon damage or rupture
- Complex Regional Pain Syndrome (CRPS), also known as Sudeck atrophy – a chronic pain condition
- Post-traumatic osteoarthritis of the wrist after intra-articular fractures
References
- German Society for Trauma Surgery (DGU): Clinical Guideline on Distal Radius Fracture, AWMF Register No. 012-015 (2021).
- Netter, F.H. – Atlas of Human Anatomy. Elsevier, 7th edition (2019).
- Court-Brown, C.M. et al. – Rockwood and Green's Fractures in Adults. Wolters Kluwer, 9th edition (2020).
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