Wrist fractures

Last reviewed: 4 Jun 2022
Last updated: 19 Jan 2022

Summary

Definition

History and exam

Key diagnostic factors

  • history of trauma or osteoporosis
  • wrist pain
  • tenderness over the distal radius
  • swelling
More key diagnostic factors

Other diagnostic factors

  • deformity
  • tenderness in the anatomic snuff-box
  • numbness in the fingers
  • hypoesthesia
  • open wound
  • absent pulse
Other diagnostic factors

Risk factors

  • trauma
  • osteoporosis
More risk factors

Diagnostic investigations

1st investigations to order

  • plain radiographs of the wrist
More 1st investigations to order

Investigations to consider

  • CT wrist
  • MRI (without contrast) wrist
  • dual-energy x-ray absorptiometry (DXA)
More investigations to consider

Treatment algorithm

INITIAL

closed

open

ACUTE

isolated fracture of distal radius

isolated scaphoid fracture

concomitant distal radius and scaphoid fractures

ONGOING

confirmed wrist fracture

Contributors

Authors

Niels W.L. Schep, MD

Trauma, Hand and Wrist Surgeon

Department of Trauma and Hand Surgery

Maasstad Hospital

Rotterdam

Netherlands

Disclosures

NWLS is an author of several references cited in this topic. He is a consultant for Synthes, Medartis, and Arthrex, and has received honoraria from The AO Foundation for teaching courses.

Acknowledgements

Dr Niels W.L. Schep would like to gratefully acknowledge Dr Jeffrey N. Lawton, Dr John R. Lien, Dr Gregory D. Byrda, Dr Tamara D. Rozental, and Dr Chaitanya S. Mudgal, previous contributors to this topic.

Disclosures

JNL is a consultant for Innomed Inc, has received honoraria from The AO Foundation for teaching courses, and has been sponsored for research by DePuy Synthes. JRL and GDB declare that they have no competing interests. TDR is an author of several references cited in this topic. CSM has been reimbursed by AO North America and Asia Pacific for being a faculty member during educational conferences.

Peer reviewers

Asif Ilyas, MD

Program Director of Hand and Upper Extremity Surgery

Rothman Institute

Associate Professor of Orthopaedic Surgery

Thomas Jefferson University

Philadelphia

PA

Disclosures

AI declares that he has no competing interests.

Isam Atroshi, MD, PhD

Associate Professor of Orthopaedics

Lund University

Chief

Hand Surgery Section

Department of Orthopaedics

Hässleholm and Kristianstad Hospitals

Sweden

Disclosures

Not disclosed.

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