Distal Radius Fracture in Vienna
A fall onto the outstretched hand, a sharp pain over the wrist, swelling and sometimes a visible deformity: that is how a distal radius fracture usually begins. Whether immobilisation is enough or stabilisation is the better choice depends on the position of the fragments. I assess the findings and accompany the treatment until you are back in your everyday life.
In short
A broken wrist, in medical terms a distal radius fracture, is a break of the radius just above the wrist joint. It is almost always preceded by a fall onto the outstretched hand; in older age, a fall from standing height is enough. If the fracture is stable, it can heal with immobilisation in a cast or splint and regular follow-up X-rays. If the joint surface is displaced or the fracture is unstable, I stabilise it surgically, usually with a locking plate. In both cases the aim is a wrist that keeps its shape and may be moved again early.
What is a distal radius fracture?
The radius is one of the two forearm bones and lies on the thumb side. At the wrist it carries most of the load and forms the joint surface for the carpal bones. A fracture of the section close to the joint is one of the most common fractures.
The way the accident happens determines the fracture pattern. If you catch the fall with the hand bent back, the fragment tilts towards the back of the hand; if you land on the back of the hand with the wrist bent forward, it tilts towards the palm side. The fracture can be compressed, break into several fragments or extend into the joint surface; a step in the cartilage permanently changes how load is distributed and later favours osteoarthritis of the wrist.
Particularly affected are younger people after a high-impact fall and older people with declining bone quality. The styloid process of the ulna often breaks as well; the same fall can also break the scaphoid or injure ligaments of the carpus.
Typical symptoms
- Immediate pain — it starts with the fall and increases with every movement.
- Swelling and bruising — the wrist swells quickly.
- Visible deformity — a step or a bayonet-shaped bend just above the hand.
- Loss of strength — gripping and leaning on the hand are barely possible, and turning the forearm hurts.
- Numbness in the fingers — a warning sign of pressure on the median nerve.
How I make the diagnosis
First I ask you to describe how the accident happened; the clinical examination follows: I palpate the wrist and the carpal bones and check circulation, sensation and tendon function. Confirmation comes from an X-ray in two planes, which I arrange; if the fracture extends into the joint surface, a CT scan is added. In the practice I use ultrasound to assess tendons and soft tissues. If symptoms remain after the bone has healed, I use an MRI to investigate a possible ligament injury of the wrist.
Treatment: conservative first
If the fracture is stable and well aligned, no operation is needed. I immobilise the wrist in a cast or splint and check the position on X-ray, because a fracture that is well aligned at first can still settle. If it is displaced, it is first reduced under anaesthesia — that is part of the initial trauma care; I then take over the further treatment.
In the meantime, what you do yourself counts: move your fingers fully, keep the arm raised and do not let the shoulder become stiff. Once the cast comes off, rebuilding begins. Physiotherapy and exercise therapy are available in the same building at the Orthozentrum Döbling, and magnetic field therapy can be used alongside. How quickly you may put load on the wrist depends on the follow-up X-ray.
When an operation is necessary
Factors in favour of stabilisation are a displaced or stepped joint surface, compression with shortening, an unstable comminuted fracture, an open fracture and pressure on the median nerve. The usual route is a locking plate inserted through an approach on the palm side; for certain fracture patterns, screws or wires are sufficient. The aim is a fixation stable enough for exercise, which allows early movement.
If a ligament injury is suspected, I examine the wrist arthroscopically under the same anaesthetic. Arthroscopy of the wrist shows the joint surface and the TFCC (the ligament complex on the little-finger side) directly, and a tear can be treated at the same time. Accompanying finger and metacarpal fractures I treat in the same operation.
I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. I describe how this works under private practice and reimbursement.
Whether an operation makes sense depends on the findings. The X-ray, the quality of the bone and what your hand needs to do at work and in sport determine the way forward — we decide on it together once I have examined you. The overview of hand surgery in Vienna shows which procedures on the hand and wrist this includes.
Frequently asked
Frequently asked questions about distal radius fractures
No. If the fracture is stable and well aligned, immobilisation in a cast or splint is sufficient; follow-up X-rays show whether the position holds. Factors in favour of an operation are a displaced joint surface, an unstable comminuted fracture, an open fracture or pressure on the median nerve. Which route is right depends on the findings.
After a fall onto the hand, pain that starts immediately, rapid swelling and a visible step suggest a fracture. A wrist that looks normal from the outside can also be broken: this is exactly why a scaphoid fracture is often missed. Only an X-ray gives certainty, which is why a painful wrist should be examined.
A narrow metal plate whose screws lock firmly into the plate. This creates a stable construct that holds the reduced position of the fragments, even when the bone is soft. I usually insert it through an approach on the palm side. The wrist is then stable enough for exercise and may be moved early.
You move your fingers from the very beginning, even in the cast: this keeps the tendons gliding and helps the swelling go down. After fixation with a plate that is stable enough for exercise, we start careful exercises for the wrist early. After immobilisation, movement begins as soon as the follow-up X-ray allows it.
The TFCC is the ligament complex on the little-finger side of the wrist that holds the radius and ulna together and guides the rotation of the forearm. It is not uncommonly torn in the same fall. If pain on the little-finger side and when twisting open a lid persists after the bone has healed, I investigate this accompanying injury.
Not necessarily. It can stay in place if it causes no problems. It is removed if it bothers you, presses on tendons or you would like it taken out; this procedure is smaller than the first operation. The prerequisite is bony union, which I check on X-ray.
Yes, that is a common reason for an appointment. I review the initial treatment and the images, check the position over time and guide the follow-up treatment. Please bring all X-rays, medical letters and previous reports. As a rule, I offer appointments within a week.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
Related
This might concern you too
Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.