Distal radius fractures are one of the most frequently reported injuries among skiers. They often occur when a skier loses balance and falls forward, instinctively reaching out with their hands to cushion the impact. This motion places significant stress on the wrist—especially while holding ski poles—making it more prone to fracture. Recognising how these injuries happen and the available treatment options can help guide a smoother, safer recovery.
What is a Distal Radius Fracture?
A distal radius fracture is a break near the wrist end of the radius, the larger of the two forearm bones. This area absorbs significant force during a fall onto an outstretched hand, which is a frequent skiing mechanism of injury.
Wrist involvement: The distal end of the radius forms part of the wrist joint. Fractures here can affect mobility and hand function.
Common in skiing: These injuries often occur when a skier falls while gripping ski poles, increasing the force applied to the wrist.
Common Types of Distal Radius Fractures
Fracture type depends on the direction and force of impact:
Extra-articular fracture: The bone breaks but the fracture line does not extend to the joint surface. The fracture may be undisplaced or displaced, stable or unstable.
Intra-articular fracture: The fracture line extends to the joint surface. This will require accurate restoration of articular congruity and reduction of any articular gap.
Comminuted fracture: The bone breaks into several pieces. This may require further investigation like a CT scan to determine the fracture pattern and possible surgical intervention.
Barton type fracture: There is a break in the distal radius, involving the volar (palm side) or dorsal (back side) of the bone. This is often associated with dislocation of the wrist joint.
Signs and Symptoms
Recognising the signs of a distal radius fracture can help skiers seek medical attention:
Pain and swelling: Pain around the wrist that increases with movement is typical. Swelling usually develops shortly after injury.
Visible deformity: The wrist may appear bent or differently shaped compared to the uninjured side.
Limited function: Difficulty moving the wrist or fingers, along with pain when attempting to grip objects.
Bruising: Discolouration around the wrist area that may develop hours or days after the injury.
Diagnosis Process
Accurate diagnosis guides appropriate treatment:
Physical examination: A hand surgeon will check for tenderness, deformity, and movement limitations of the injured wrist.
X-rays: Views of the wrist to confirm the fracture and determine its pattern and displacement.
CT scan: A hand surgeon may recommend a CT scan for complex, comminuted or articular fractures involving the joint surfaces.
Treatment Options
Non-Surgical Treatment Options
Stable or minimally displaced fractures can often be treated conservatively:
Closed reduction: A procedure where the hand surgeon manually realigns the broken bone fragments without surgery. This is typically performed with anaesthesia.
Cast immobilisation: After reduction, a cast is applied to hold the bones in position while they heal.
Surgical Treatment Options
Surgery is considered for fractures that are unstable, displaced, or involve the joint surface:
Minimally Invasive Fixation: For fractures that are unstable, significantly displaced, or involve the growth plate or joint surface, a hand surgeon may recommend surgical fixation using K-wires, low-profile plates, or screws. These procedures are performed with precision to protect future bone growth, restore wrist alignment, and ensure optimal functional recovery.
Recovery Timeline
Healing depends on fracture type, treatment, and overall health:
Immediate (0-2 weeks): Focus on pain management, swelling reduction, and protecting the fracture.
Early recovery (2-6 weeks): Cast or splint remains in place, with gradual introduction of gentle finger exercises.
Mid recovery (6-12 weeks): Transition from cast to removable splint, beginning controlled wrist movements and gentle strengthening.
Long-term recovery (3-6 months): Gradual return to activities, including skiing, with continued exercises.
When to Return to Skiing
Returning to skiing should be guided by healing status and functional recovery:
Bone healing: X-rays typically show adequate healing before considering returning to skiing.
Functional readiness: Adequate wrist motion and strength are considerations before returning to skiing.
Protective equipment: Wrist guards during the first season after a fracture can provide additional support.
Potential Complications
Understanding possible issues helps with early intervention:
Stiffness: Limited wrist or finger motion can occur, particularly without rehabilitation.
Malunion: When the fracture heals in a position that may lead to functional limitations.
Arthritis: Fractures that extend into the joint surface can be associated with wrist arthritis over time.
Prevention Strategies for Future Ski Seasons
Risk of future injury can be reduced through preparation and awareness:
Equipment considerations: Well-fitting gloves and wrist guards, particularly for beginner and intermediate skiers.
Technique awareness: Learning falling techniques can help reduce the tendency to land on outstretched hands.
Physical preparation: Strengthening wrist and forearm muscles before ski season can provide better support.
Conclusion
Distal radius fractures from skiing accidents are treated based on fracture characteristics and individual factors. With appropriate care and rehabilitation, many patients experience good functional recovery. If you’ve sustained a wrist injury while skiing, consult with a hand specialist to discuss treatment options suited to your specific situation.
FAQs
Will my wrist regain full range of motion and strength after surgery?
Most patients recover good function, but full range of motion may not always return—especially after complex fractures. Rehabilitation with a hand therapist, guided by your hand surgeon, can help optimise recovery.
Are there any long-term activity restrictions after a wrist fracture from skiing?
Most people return to normal activities, including skiing. However, those with joint surface involvement or stiffness may need to avoid high-impact wrist loading or modify certain techniques.
What type of wrist support is recommended when returning to skiing after recovery?
Wrist guards or padded supports can help reduce the risk of reinjury, especially during the first season after healing. A hand surgeon can recommend appropriate protective gear.
How can I tell if ongoing wrist pain after recovery is normal or a sign of complication?
Mild stiffness or soreness can persist for a few months. However, sharp pain, swelling, reduced function, or clicking may signal complications such as joint irritation or post-traumatic arthritis and should be evaluated by a hand surgeon.
