Distal Radius Fracture

A distal radius fracture is a break of the radius within a few centimetres of the wrist joint, usually after a fall onto an outstretched hand.

It is one of the most common fractures in adults, with 2 peaks: higher-energy injuries in young adults (sport, falls from height, road traffic collisions) and low-energy fragility fractures in older adults, mostly women.

Most fractures are treated without surgery. In UK practice the aim is functional recovery rather than a perfect X-ray, and a low-energy fracture in an older adult is a prompt to assess bone health and falls risk.

The distal radius carries most of the axial load across the wrist. Its articular surface has the scaphoid and lunate fossae (radiocarpal joint) and the sigmoid notch (distal radioulnar joint, DRUJ). Lister's tubercle on the dorsal surface is the pulley for extensor pollicis longus (EPL), which can rupture weeks after a fracture.

Classic patterns:

• •Colles: extra-articular, dorsally angulated, after a fall on an outstretched hand; the 'dinner-fork' deformity
• •Smith: volarly angulated ('reverse Colles'), often from a fall onto a flexed wrist; unstable
• •Barton: intra-articular fracture of the volar or dorsal rim with the carpus displaced with the fragment
• •Chauffeur: radial styloid fracture
• •Die-punch: impaction of the lunate fossa, easily missed on plain films

Clinical practice usually describes the pattern, displacement and articular involvement rather than a formal classification.