Radius Fracture

First aid

• support the arm in a sling or against the body
• do not try to straighten it
• apply ice wrapped in a cloth and raise the arm
• remove rings, watches and bracelets
• take acetaminophen (paracetamol) or ibuprofen at the label dose
• go to an urgent care center or ER

Types of radius fracture

Causes and risk factors

• falls on an outstretched hand: the most common mechanism
• osteoporosis: a wrist fracture in an older adult is often the first sign
• sports: skiing, snowboarding, skating, cycling, football
• car and motorcycle crashes

Symptoms

• immediate pain, worse with movement
• swelling and bruising
• deformity, such as a bent wrist
• tenderness over the bone
• difficulty moving the wrist, rotating the forearm or gripping
• numbness or tingling in the fingers from swelling pressing on the median nerve

Diagnosis

The doctor checks circulation, nerve function and skin, then orders X-rays of the wrist, forearm and elbow. CT scans help plan treatment for fractures into the joint. Doctors also look for associated injuries, such as scaphoid fracture and ligament tears.

Treatment

Non-surgical

• Stable, non-displaced fractures: a splint at first while swelling settles, then a cast for about 4 to 6 weeks
• Displaced fractures: closed reduction (setting the bone) under local anesthetic or sedation, then a cast, with repeat X-rays at 1 and 2 weeks to make sure the position holds
• In older, less active adults, some angulation is often acceptable without surgery, with similar functional results

Surgery

Surgery is considered when the fracture:

• is unstable or slips after reduction
• involves the joint surface with a step or gap
• is open, or involves multiple fractures
• is in a young, active person with significant displacement

Options include a volar locking plate (most common), pins (K-wires) or external fixation. Early motion is often possible after plating.

Radial head fractures

Minimally displaced ones are treated with a sling and early elbow movement. Displaced fractures may need fixation or radial head replacement.

Recovery

Hand therapy restores wrist, finger and forearm motion and grip strength. Move your fingers, elbow and shoulder from the start to prevent stiffness.

Complications

• stiffness and reduced grip strength
• malunion: healing in a poor position, causing deformity or limited motion
• post-traumatic arthritis after joint fractures
• carpal tunnel syndrome from swelling
• complex regional pain syndrome: severe burning pain, swelling and color change out of proportion to the injury
• tendon rupture, particularly of the thumb tendon, weeks later
• hardware irritation after plating

Bone health

A wrist fracture from a fall from standing height in someone over 50 is a fragility fracture. Ask about a bone density test, calcium and vitamin D, exercise and osteoporosis treatment to prevent future hip and spine fractures.

Frequently asked questions

How long does a broken radius take to heal?

The bone usually heals in 6 to 8 weeks. Most people wear a cast or splint for 4 to 6 weeks. Returning to heavy lifting and sports often takes 3 months, and full strength and movement can take 6 to 12 months.

What is a Colles fracture?

It is a break of the radius near the wrist in which the broken end tilts toward the back of the hand, creating a "dinner fork" deformity. It usually happens from falling onto an outstretched hand and is common in older adults with osteoporosis.

Does a distal radius fracture need surgery?

Not always. Many heal well in a cast, sometimes after the bone is set. Surgery is recommended for unstable fractures, those involving the joint surface, open fractures, or significant displacement in active people.

Can you move your fingers with a broken wrist?

Often yes, and you should keep moving your fingers, elbow and shoulder to prevent stiffness. Being able to move your fingers does not rule out a fracture. Numbness or inability to move the fingers needs prompt assessment.