Distal radius fractures can be treated in several ways, ranging from simple casting to the surgical placement of complex metal fixtures.
Despite the many research studies that have been done concerning the treatment of distal radius fracture, there is no consensus on the best treatment protocol. Therefore, treatment decisions should be made based on each patient’s circumstance.
There are several factors that physicians and patients need to consider when determining how to a distal radius fracture should be treated:
- The age and activity level of the patient
- The nature of the fracture
- Whether the fractured bone has lower bone density (osteopenia or osteoporosis)
- The expertise and experience of the surgeon for a specific surgical approach
Below is a guide to the main nonsurgical approaches for a distal radius fracture.
A closed reduction involves resetting the bone without surgery. If a closed reduction is determined to be appropriate for treating the fracture, the patient is typically given a local anesthesia option to numb the surgical area. Patients may also receive a light sedative. Then the bones are manipulated back into position, sometimes with the assistance of small slings on the fingers that provide pulling traction. Use of general anesthesia for this procedure is rare.
Once any reduction efforts have been completed, the wrist is placed in a cast or splint to keep it in position while bones heal. A splint may be used initially to allow swelling to go down, then the splint can be replaced with a sturdier cast.
Closed Reduction with Percutaneous Pinning
If there is a danger that resetting may not be maintained from a cast alone, surgeons can add a few small pins, known as Kirschner wires, to hold bone fragments together. Because the wires are thin and only require a needle puncture to place them rather than an incision, this is still considered a closed reduction.
The pins can be inserted under local anesthesia at the same time as the reduction procedure. They are often used in conjunction with either external fixation or casting. The pins will be removed in a few weeks, once healing of the fracture is evident and/or the cast is removed.