Distal Radius Fracture Surgery

Distal Radius Fracture Treatment and Surgery in North Georgia

A distal radius fracture, commonly called a broken wrist, occurs when the radius bone breaks near the wrist joint. It is one of the most common wrist injuries and frequently occurs after a fall on an outstretched hand or arm. Distal radius fractures can also result from a sports injury, car accident, work-related accident, or other high-energy injury.

If you have already been evaluated at an emergency room or urgent care and were told that you have a wrist fracture, early treatment and appropriate orthopedic follow-up are important. The initial splint protects the wrist, but the next step is determining whether the fracture is in satisfactory alignment, whether it is stable, and whether it can heal properly without surgery.

Dr. Thomas Neustein is a board-certified, fellowship-trained orthopedic hand and upper-extremity surgeon who treats distal radius fractures in Dawsonville, Duluth, Braselton, Gainesville, and throughout North Georgia. Treatment options range from closed reduction, casting, and removable splinting to surgical fixation for unstable or displaced fractures.

What Is a Distal Radius Fracture?

The radius is the larger of the two forearm bones at the wrist and is located on the thumb side of the forearm. A distal radius fracture occurs when the end of the radius breaks close to the wrist joint and nearby carpal bones.

The severity of these fractures varies considerably. Some stable fractures remain in proper alignment and can be treated without surgery. Other fractures are displaced, unstable, comminuted into multiple fracture fragments, or extend into the wrist joint.

The fracture pattern, degree of displacement, joint involvement, bone quality, patient age, activity level, and functional demands all help determine the appropriate treatment plan.

Types of Distal Radius Fractures

Distal radius fractures can be described according to their fracture pattern, alignment, and involvement of the wrist joint.

Common types include:

• Colles fracture – a common fracture pattern in which the distal radius is displaced or tilted toward the back of the wrist
• Smith fracture – a fracture pattern in which the distal radius is displaced toward the palm
• Extra-articular fracture – a fracture that does not extend into the joint surface
• Intra-articular fracture – a fracture that extends into the wrist joint
• Displaced fracture – the fracture fragments have moved out of their normal alignment
• Comminuted fracture – the bone has broken into multiple fragments
• Radial styloid fracture – a fracture involving the radial styloid on the thumb side of the wrist
• Open fracture – a more serious injury in which the fracture communicates with a wound through the skin

Distinguishing between stable fractures and unstable fractures is particularly important because an unstable fracture may lose alignment even after it has initially been reduced and placed into a cast or splint.

Most distal radius fractures involve the radius alone, but more severe injuries can occur together with other wrist or forearm fractures. Associated injuries can include an ulna fracture, scaphoid fracture, or other injuries involving the wrist bones and surrounding soft tissues.

Complex fractures, particularly intra-articular fractures, may cause significant damage to the joint surface and require more detailed evaluation and treatment.

How Do Distal Radius Fractures Happen?

A fall on an outstretched hand or arm is one of the most common causes of a distal radius fracture. The force travels through the wrist and can cause the radius to break near the joint.

In younger patients, severe fractures are more likely to result from higher-energy trauma such as sports injuries, falls from height, or motor vehicle accidents.

In older adults, a relatively minor fall may cause a wrist fracture because reduced bone density can make the bone more vulnerable to injury. Age, osteoporosis, fall risk, and certain activities are therefore important risk factors for wrist fractures.

A low-energy wrist fracture in an older adult can also be an opportunity to evaluate underlying bone health and future fracture risk.

Symptoms of a Broken Wrist

A distal radius fracture often causes immediate pain, swelling, and difficulty using the wrist.

Common symptoms include:

• Wrist pain after a fall or injury
• Swelling and bruising
• Difficulty moving the wrist
• Tenderness around the wrist joint
• Visible deformity or a bent wrist
• Difficulty gripping or using the hand
• Numbness or tingling in the fingers

Numbness or tingling can sometimes occur because swelling or fracture displacement places pressure on the median nerve at the wrist.

Open wounds, severe deformity, loss of sensation, changes in the color or temperature of the fingers, or other signs of injury to nerves or blood vessels require urgent medical attention.

I Was Told I Have a Broken Wrist. What Happens Next?

Many patients first learn that they have a distal radius fracture at an emergency room or urgent care center. The wrist may undergo a closed reduction if necessary and be placed into a plaster splint or other temporary immobilization while swelling improves.

A closed reduction means the broken bones are manipulated back toward proper alignment without making a surgical incision.

The next step is orthopedic evaluation to assess alignment and determine whether the fracture is likely to remain stable as it heals.

Dr. Neustein reviews the patient's X-rays and examines the wrist, hand, nerves, and soft tissues. The goal is to determine whether nonsurgical treatment is appropriate or whether surgical fixation offers a better way to restore and maintain alignment.

This evaluation is particularly important for an unstable or displaced fracture because fracture displacement can change during the first several days or weeks after injury.

Diagnosis and Imaging

Diagnosis begins with a history, physical examination, and X-rays of the wrist.

X-rays allow Dr. Neustein to assess:

• Fracture displacement
• Overall wrist alignment
• Joint involvement
• The number and position of fracture fragments
• Angulation or shortening of the radius
• Associated injuries to the carpal bones or forearm

For complex intra-articular fractures, a CT scan may be useful to better define the fracture fragments and joint surface and assist with surgical planning.

Imaging is considered together with the patient's examination, age, bone quality, activity level, occupation, and functional needs when developing the treatment plan.

Can a Distal Radius Fracture Heal Without Surgery?

Yes. Many distal radius fractures can be successfully treated without surgery.

Nonsurgical treatment may be appropriate when the fracture is stable or can be reduced into satisfactory alignment and is expected to remain in that position while the broken bones heal.

Treatment may include a splint followed by a cast or removable splint or brace. Repeat X-rays are often obtained during follow-up to make sure the fracture maintains proper alignment and progresses toward proper healing.

Nonsurgical treatment is commonly considered for:

• Nondisplaced or minimally displaced fractures
• Stable fractures
• Fractures that maintain satisfactory alignment after closed reduction
• Certain lower-demand patients
• Patients for whom the risks of surgery outweigh the potential benefits

The decision is individualized. An X-ray that looks imperfect does not automatically mean surgery is necessary, particularly when considering patient age, activity level, bone quality, and functional goals.

How Long Is a Wrist Immobilized After a Distal Radius Fracture?

The length of immobilization depends on whether the fracture is treated nonsurgically or surgically.

For stable fractures treated without surgery, a cast or splint is commonly used for approximately 4 to 6 weeks, although the exact duration depends on the fracture pattern, X-rays, and progression of bone healing. Some stable fractures may remain in a cast for approximately six weeks.

Casts may occasionally need to be changed during the healing period as swelling decreases or the fit changes. Repeat X-rays help determine whether the fracture remains in acceptable alignment while it heals.

Physical therapy or hand therapy may begin after cast removal to restore wrist motion, strength, and function.

Recovery after surgical fixation is different. Stable internal fixation can allow gentle wrist motion to begin much earlier. With Dr. Neustein's typical protocol, patients transition from the postoperative splint to a removable brace at approximately one week and can usually begin gentle range of motion at that time when the fracture and fixation permit.

Complex fractures, particularly those with significant joint involvement or extensive damage to the joint surface, may require a slower rehabilitation process.

Overall recovery from a distal radius fracture commonly takes approximately 3 to 6 months, including rehabilitation, although recovery varies substantially with the severity of the injury. Motion, strength, and function may continue improving beyond that period, and most patients can return to their normal activities within a year.

When Does a Distal Radius Fracture Need Surgery?

Wrist surgery is generally considered when the fracture cannot be restored to or maintained in satisfactory alignment with nonsurgical treatment.

Reasons surgical management may be recommended include:

• Significant fracture displacement
• An unstable fracture that is likely to shift
• Loss of alignment after an initial closed reduction
• Significant shortening or angulation
• Intra-articular fractures with unacceptable joint displacement
• Multiple fracture fragments that cannot be adequately controlled in a cast
• Open fractures
• Certain associated wrist or forearm injuries

The decision to operate is not based on a single X-ray measurement. Dr. Neustein considers the entire injury as well as patient age, activity level, hand dominance, occupation, bone quality, and goals.

The objective of treatment is to obtain satisfactory alignment and fracture healing while ultimately restoring wrist function and allowing the patient to return to normal activities.

Distal Radius ORIF: Wrist Fracture Surgery

The most common surgical treatment for an unstable or displaced distal radius fracture is open reduction and internal fixation, often abbreviated ORIF.

“Open reduction” means the fracture fragments are directly visualized and restored to proper alignment through a surgical incision. “Internal fixation” means an implant is used to hold the fracture securely while the bone heals.

For many distal radius fractures, this involves volar plating. A volar locking plate is positioned along the palm side of the radius and secured with screws.

The goal of surgical fixation is to restore the anatomy of the wrist and provide stable internal fixation while the fracture heals. When the fracture pattern and fixation permit, this stability can also allow controlled wrist motion relatively early in recovery rather than requiring prolonged immobilization.

Are There Other Types of Wrist Fracture Surgery?

Although volar locking plate fixation is commonly used, not every distal radius fracture is identical.

Depending on the fracture pattern, surgical treatment may occasionally involve:

• Fragment-specific fixation
• Percutaneous pinning
• Additional plates or screws
• A dorsal spanning or bridge plate
• A combination of fixation techniques

External fixation with an external fixator has historically been used for certain severe distal radius fractures. Dr. Neustein generally prefers a bridge plate when additional spanning fixation is required rather than an external fixator.

The surgical technique is selected based on the individual fracture rather than using the same fixation method for every patient.

What Type of Anesthesia Is Used for Distal Radius Fracture Surgery?

Distal radius fracture surgery can be performed using different types of anesthesia depending on the patient and procedure.

When appropriate, Dr. Neustein generally prefers regional anesthesia, or a nerve block, which numbs the operative arm and can provide significant pain relief after surgery. Local anesthesia may also be used as part of the anesthetic plan. General anesthesia is not always necessary.

The final anesthesia plan is individualized in coordination with the anesthesia team.

What to Expect After Distal Radius Fracture Surgery

After surgical fixation, the wrist is initially protected in a postoperative splint. Finger motion is encouraged early to help reduce stiffness and swelling.

Dr. Neustein's typical postoperative protocol after stable distal radius fixation emphasizes early controlled motion while continuing to protect the healing fracture.

First Week

The wrist remains protected in the postoperative splint. Patients generally return approximately one week after surgery for their first postoperative evaluation.

At Approximately One Week

Patients are typically transitioned into a removable wrist brace. When the fracture and fixation are stable, gentle wrist range of motion can usually begin at this stage.

The brace can generally be removed for hygiene and prescribed exercises while continuing to protect the wrist during other activities.

Weeks 1–4

Patients gradually increase wrist motion and hand use while continuing the removable brace for protection. Brace use is reduced as healing, comfort, fracture stability, and the individual patient's progress allow.

More complex or unstable fracture patterns may require a slower progression.

Around Four Weeks

Many patients can substantially reduce or discontinue use of the brace and focus more on restoring wrist motion and normal light use of the hand, depending on X-rays and clinical healing.

After Approximately Two Months

Progressive strengthening generally begins once fracture healing is satisfactory. Grip strength, wrist strength, and endurance are then gradually rebuilt.

This timeline is a general framework rather than a rigid protocol. Fracture severity, bone quality, associated injuries, fixation stability, and healing can all change the pace of rehabilitation.

Physical Therapy After a Wrist Fracture

Physical therapy or specialized hand therapy can play an important role in restoring wrist function after a distal radius fracture.

Depending on the injury and treatment, patients may start physical therapy or hand therapy to improve:

• Wrist and forearm range of motion
• Finger and thumb mobility
• Swelling and stiffness
• Grip strength
• Wrist strength and endurance
• Functional use of the hand
• Return to work, sports, and everyday activities

The timing and intensity of therapy depend on the fracture and treatment. After nonsurgical treatment, therapy may begin once immobilization is reduced or the cast is removed. Following surgery with stable internal fixation, controlled motion can often begin much earlier.

How Long Does a Distal Radius Fracture Take to Heal?

Bone healing and complete functional recovery are not the same thing.

The fracture progressively heals over the first several weeks and months, but wrist motion, strength, endurance, and comfort can continue improving long after the bone has united.

For many patients, meaningful recovery occurs over approximately 3 to 6 months, including rehabilitation. Many patients return to a large portion of their normal activities during this period.

Full recovery varies considerably depending on the severity of the original injury, patient age, bone quality, stiffness, associated injuries, and functional demands. Improvement in functional outcomes can continue for many months, and most patients can return to their normal activities within a year.

The goal throughout recovery is not simply to heal the broken bone, but to reduce pain, restore wrist function, and allow a safe return to work, recreation, and everyday activities.

Potential Complications of Distal Radius Fractures and Surgery

Most fractures heal successfully, but potential complications can occur after either the original injury or surgical treatment.

Possible complications include:

• Wrist stiffness or loss of motion
• Persistent pain or swelling
• Numbness or median nerve irritation
• Tendon irritation or tendon injury
• Infection
• Delayed union or nonunion
• Loss of fracture alignment
• Hardware irritation
• Post-traumatic arthritis
• Complex regional pain syndrome
• Need for additional surgery

Certain severe fractures carry a greater risk of stiffness, arthritis, and other complications because of the damage caused by the original injury.

Careful fracture reduction, stable fixation when surgery is required, early appropriate motion, and follow-up throughout healing are intended to reduce these risks and maximize wrist function.

When Can I Return to Work or Sports?

Return to work depends on the fracture, treatment, healing, and the physical demands of the patient's job.

Patients performing desk work may return considerably earlier than those whose jobs require lifting, gripping, tools, repetitive hand use, or other physically demanding activities.

Return to sports also varies according to the activity and risk of another fall or impact to the wrist.

Dr. Neustein provides individualized activity and work restrictions as the fracture heals rather than using the same timeline for every patient.

Bone Health After a Wrist Fracture

In older adults, a distal radius fracture after a relatively minor fall can sometimes be an early sign of reduced bone strength.

Depending on patient age and risk factors, evaluation may include discussion of:

• Bone density testing
• Calcium and vitamin D intake
• Weight-bearing exercise
• Fall prevention
• Osteoporosis evaluation and treatment when appropriate

For women over 50 and other patients with risk factors for osteoporosis, a low-energy wrist fracture may be an appropriate reason to discuss bone density testing and bone health with their physician.

Identifying poor bone health after a fracture may help reduce the risk of future broken bones.

Why Choose Dr. Neustein for a Distal Radius Fracture?

Dr. Thomas Neustein is a board-certified orthopedic surgeon with fellowship training in hand and upper-extremity surgery. Distal radius fractures involve both fracture care and the complex anatomy of the wrist, and Dr. Neustein treats injuries ranging from straightforward stable fractures to severe intra-articular and comminuted injuries requiring surgical fixation.

Treatment is individualized rather than assuming that every broken wrist needs surgery. When surgery is appropriate, Dr. Neustein uses modern fixation techniques designed to restore alignment, provide stable fixation, and support recovery of wrist function.

Distal Radius Fracture Treatment in Dawsonville, Duluth, Braselton, and Gainesville

Dr. Neustein evaluates and treats patients with distal radius fractures in Dawsonville, Duluth, Braselton, Gainesville, and throughout North Georgia.

If you have been told at an emergency room, urgent care center, or another medical office that you have a broken wrist, timely orthopedic follow-up can determine whether the fracture is stable, whether the alignment is satisfactory, and whether nonsurgical treatment or surgery is appropriate.

Schedule an appointment with Dr. Thomas Neustein for evaluation of a distal radius fracture, broken wrist, or other hand and wrist injury.