Distal radius fractures are among the most common upper extremity fractures. They represent about one-sixth of all emergency department fractures. Risk factors in the elderly include low bone density, female sex, and falls from standing height. Clinically, there is wrist deformity, swelling, and pain with motion. Radiographs of the wrist and potentially the elbow are needed to classify and further evaluate the fracture. Treatment may involve casting, external fixation, or plating depending on the fracture type and location. Rehabilitation aims to control symptoms and regain range of motion and strength.

1. Distal Radius #
Dr. Ashish S
Asst. Professor
Department of Musculoskeletal Sciences
DVVPF’s College of Physiotherapy, Ahmednagar

2. EPIDEMIOLOGY
• Distal radius fractures are among the most common
fractures of the upper extremity.
• Fractures of the distal radius represent approximately
one-sixth of all fractures treated in emergency
departments.
• Risk factors for fractures of the distal radius in the elderly
include decreased bone mineral density, female sex,
white race, family history, and early menopause.

3. MECHANISM OF INJURY

4. MECHANISM OF INJURY
• Common mechanisms in younger individuals include
falls from a height, motor vehicle accident, or injuries
sustained during athletic participation. In elderly
individuals, distal radial fractures may arise from low-
energy mechanisms, such as a simple fall from a
standing height.
• The most common mechanism of injury is a fall onto an
outstretched hand with the wrist in dorsiflexion.

5. CLINICAL EVALUATION
• Patients typically present with variable wrist deformity and
displacement of the hand in relation to the wrist The wrist is
typically swollen with ecchymosis, tenderness, and painful
range of motion.
• The ipsilateral elbow and shoulder should be examined for
associated injuries.
• A careful neurovascular assessment should be performed,
with particular attention to median nerve function. Carpal
tunnel compression symptoms are common (13% to 23%)
owing to traction during forced hyperextension of the wrist,
direct trauma from fracture fragments, hematoma formation,
or increased compartment pressure.

6. RADIOGRAPHIC EVALUATION
• Posteroanterior and lateral views of the wrist should be
obtained, with oblique views for further fracture
definition, if necessary. Shoulder or elbow symptoms
should be evaluated radiographically.

8. Classification by fernandez
• Type 1- bending type , extra articular , metaphyseal #.
Displacement dorsal- colle’s, volar – smith’s.
• Type 2- articular # with volar or dorsal with radial styloid
#(chauffeur’s #) and lunet facet.
• Type 3- compression # with displacement of radial
articular surface, separation of scaphoid and lunet facet.

9. • Type 4 – radiocarpal # dislocation with avulsion #.
• Type 5- combined features of all other types and may
also involve forearm compartmental syndrome, open
wound or associated injury forearm or elbow.

11. Eponyms
• Colle’s fracture
• Smith fracture (reverse Colle’s fracture)
• Barton fracture
• Radial styloid fracture

12. COMPLICATIONS
• Stiffness of joints
• Mal-union
• Subluxation of inferior radio-ulnar joint
• Carpel- tunnel syndrome
• Sudeck’s osteodystrophy
• Rupture of the extensor pollicis longus tendon

13. Immediate Treatment
• Non- surgical
• Surgical
– Bridging external fixation
– Non-bridging external fixation
– Dorsal plating
– Radial column plating
– Volar plating

14. Goals of Rehabilitation
• Short term goals
– Control pain
– Reduce contractures
– Reduce inflammation
• Long term goals
– Improve and maintain ROM
– Improve and mainatin strength
– Allow patient to be psychologically ready to return

15. Thank You