Is the right distal radius fracture serious?

Right distal radius fracture is relatively common in life, accounting for about 1/10 of the total fractures. It is more common in middle-aged and elderly people, especially elderly women. Due to osteoporosis, fractures in this area are likely to occur. It is relatively serious because fractures will cause swelling and pain, and the mobility of the hand and wrist is significantly limited. Timely treatment is needed at this time, and elderly friends should strengthen good conditioning.

Is right distal radius fracture serious?

Distal radius fractures are very common, accounting for about 1/10 of normal fractures. It is more common in elderly women, while those occurring in young and middle-aged people are usually those with severe trauma or violence. The fracture occurs within 2 to 3 cm of the distal radius. It is often accompanied by damage to the radiocarpal joint and distal radioulnar joint.

The wrist is swollen and tender, and the movement of the hand and wrist is limited. Extension fractures have typical fork-like and stab-like deformities, the ulnar and radial styloid processes are in the same plane, and the ruler test is positive. The deformity of a flexion fracture is the opposite of that of an extension fracture. Note whether the median nerve is damaged.

treat

1. Non-displaced fractures

Use a plaster quadriceps band or a small splint to fix the wrist joint in a functional position for 3 to 4 weeks.

2. Displaced extension fracture or flexion fracture

Many manual reduction methods were successful. For extension fractures, non-comminuted fractures without involving the articular surface, the traction-shaking reduction method is often used; for elderly patients, comminuted fractures, and those with involving the articular surface, the lifting-pressing reduction method is often used. After reduction, the wrist joint is kept in palmar flexion and ulnar deviation, and fixed with plaster or external fixator for 4 weeks. After longitudinal traction, the reduction direction of flexion fractures is opposite. After reduction, the wrist joint is fixed in dorsiflexion and pronation positions for 4 weeks. In addition to taking X-rays to check the alignment after fixation, re-examination is required after the swelling has subsided in about a week. If displacement occurs again, it should be handled promptly.

3. Comminuted fracture

If reduction is difficult or difficult to maintain (such as Barton fracture), surgical reduction and internal fixation with Kirschner wires, screws or T-shaped plates are often required.

4. Treatment of Comorbidities

If fracture deformity leads to functional impairment, surgery should be performed to correct the deformity and internal fixate the fracture. If the distal radioulnar joint dislocation affects the forearm rotation, the ulna head can be removed. If the patient has median nerve injury and has not recovered after 3 months of observation, the nerve should be explored and released, and the protruding bone ends should be smoothed. For delayed extensor pollicis tendon rupture, osteophytes should be removed and the tendon repaired. People with osteoporosis should be given appropriate treatment to prevent the occurrence of other serious fracture complications (such as femoral neck fracture).

5. Functional exercise

During the fracture fixation period, attention should be paid to shoulder, elbow and finger activity exercises. Especially the elderly should prevent shoulder joint stiffness.