Distal Radius Fracture (Wrist)

Description

The radius is the larger of the two forearm bones, on the thumb side. A distal radius fracture is a break near the wrist end of that bone. It is the single most common broken bone of childhood, usually from a fall onto an outstretched hand.

How it happens (the mechanism)

When a child falls onto an outstretched hand, the force travels up the arm and concentrates just above the wrist, in the flared transition zone of the radius called the metaphysis. This part of a child’s bone is more porous and a little softer than the dense shaft, so it tends to give way there first. Depending on the load, the bone may simply crumple on one side (a buckle), bend, or break across.

This spot also sits right next to the wrist’s very active growth plate — which is good news, because that nearby growth gives the bone a strong ability to remodel and straighten itself as the child grows.

Symptoms

Pain, swelling, and tenderness just above the wrist, often with a visible bump or bend, and reluctance to use the hand.

Doctor examination and imaging

The doctor checks the wrist for tenderness, swelling, and alignment, and confirms the hand’s feeling and circulation. X-rays from two angles show the fracture and how far it has tilted or shifted.

Treatment

A fracture in good position is treated in a cast or, for very stable patterns, a removable splint, usually for about four to six weeks.

If the bone is tilted or shifted, the doctor gently sets it back into place (a reduction), generally with numbing medicine, and then casts it. Because this break remodels so well, a small amount of residual tilt is often acceptable in a young child. Surgery is rarely needed.

Recovery and long-term outlook

Children’s wrists heal quickly and remodel well, so the outlook is excellent. A few follow-up X-rays confirm the bone stays in good position while it heals.

When to call the doctor

Call the office right away if your child’s fingers become numb, pale, blue, or cold; pain keeps worsening even after raising the arm and giving medicine; swelling does not improve with elevation; the cast feels too tight, cracked, or wet, or smells bad; or your child develops a fever.

Learn more

OrthoInfo (AAOS) — Forearm Fractures in Children: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.