Wrist fractures are among the most common bone injuries in children. The distal radius—the part of the forearm bone closest to the wrist—is the most frequently broken bone in childhood. This article helps parents understand what happens when a child breaks their wrist, how a hand specialist diagnoses and treats these fractures, and what recovery typically involves.
What is a Distal Radius Fracture?
A distal radius fracture occurs when the lower end of the radius bone (the larger of the two forearm bones) breaks near the wrist.
Location: The term “distal” refers to the end of the bone closest to the wrist.
Frequency: These fractures make up around 20% of all fractures in children.
Growth plate involvement: In children, the break may involve the growth plate (physis)—a softer area of developing bone—which requires careful monitoring to support normal bone development.
How Children’s Fractures Differ from Adults
Children’s bones have unique properties that affect how they fracture and heal:
Greenstick fractures: Children’s bones are more flexible and may bend or partially break rather than completely snap (like a green twig), commonly referred to as a “greenstick fracture.”
Healing time frame: Children typically heal bone injuries in 4-6 weeks, faster than adults, who may take 6–12 weeks.
Remodelling ability: Children’s bones have the ability to straighten out over time through a process called remodelling, which is more effective in younger children.
Causes and Risk Factors
Several factors make distal radius fractures common in children:
Falls: The most typical cause is falling onto an outstretched hand while playing, riding bikes, or participating in sports.
Playground accidents: Falls from climbing frames, monkey bars, and trampolines are frequent causes.
Sports injuries: Activities like skateboarding, football, and gymnastics present higher risks.
Bone health: Some children may have weaker bones due to nutritional factors or certain medical conditions.
Signs Your Child May Have a Distal Radius Fracture
Recognising the signs of a fracture can help you seek prompt medical attention.
Pain and swelling: The wrist area becomes painful, tender, and swollen shortly after injury.
Visible deformity: The wrist may appear bent or crooked in more severe fractures.
Limited movement: Your child may resist moving the wrist or show distress when attempting to use the hand.
Bruising: Discoloration around the wrist may develop within hours or days after injury.
Diagnosis Process
At a specialist hand clinic, the doctor will:
Take a history: Ask about how the injury happened and your child’s symptoms.
Physical examination: Gently assess the wrist, checking for tenderness, swelling, and deformity.
X-rays: Order imaging to confirm the fracture, determine its location, and check if bones are displaced.
Additional imaging: Sometimes CT scans or MRIs may be needed for complex fractures or when growth plate involvement is suspected.
Treatment Options for Distal Radius Fractures
Treatment varies depending on the fracture severity and the child’s age.
Casting & Splinting: Most uncomplicated fractures are treated with a customised cast or splint, to ensure secure immobilisation and comfort.
Closed reduction: For displaced fractures, the hand specialist may need to realign the bones without surgery, usually using sedation or local anaesthesia.
Growth Plate Monitoring: If the growth plate is involved, periodic follow-up appointments will be scheduled with repeat x-rays to track bone development and prevent long-term issues.
Regular Follow-Up Care: After treatment, your child will receive close monitoring at 1–2 week intervals initially, with adjustments to the care plan based on healing progress and mobility.
Recovery Timeline and Expectations
Recovery usually progresses well with appropriate care:
Cast duration: Most children wear a cast for 3–6 weeks, depending on age and fracture type.
Pain improvement: Discomfort typically reduces significantly within the first week.
Activity restrictions: Physical activities, including sports and rough play, should be avoided until cleared by a hand specialist
Return to normal activities: Full recovery may take up to 2–3 months, with a gradual return to normal play and sports.
Home Care Tips for Distal Radius Fractures
These strategies can help your child recover comfortably at home:
Elevation: Keep the injured arm elevated on pillows when sitting or lying down to reduce swelling.
Cold packs: Apply a cold pack (wrapped in a towel) for 15–20 minutes several times a day during the first 48 hours.
Cast care: Keep the cast dry and avoid inserting objects under it when your child complains of itching.
Pain relief: Administer only medications prescribed or approved by your child’s hand surgeon. Avoid over-the-counter use without clinical guidance.
When to Seek Further Medical Attention
Contact a hand specialist if your child experiences:
Increasing pain: Pain that worsens despite rest and medication.
Numbness or tingling: Sensations in the fingers that persist or worsen.
Cast problems: A cast that becomes tight, loose, wet, or develops a strong odour.
Fever: Temperature above 38°C, which could indicate infection.
Conclusion
Wrist fractures are a common childhood injury. With timely and appropriate treatment from a specialist, most children achieve full functional recovery under the care of a qualified hand surgeon.
FAQs
Will the fracture affect my child’s future bone growth?
If the growth plate is involved, regular follow-up is important to monitor development. In most cases, children recover fully with no long-term issues when monitored appropriately.
How soon should my child return to school or sports?
Children can usually return to school shortly after the injury, but physical activities—especially contact sports—should be avoided until cleared by a hand specialist, typically after 6–8 weeks.
What should I do if my child’s cast gets wet or damaged?
Contact your hand specialist clinic promptly if the cast becomes wet, cracked, or starts to smell. Moisture can weaken the cast and increase infection risk.
