Wrist fractures are a common childhood injury, particularly among active children who engage in sports or outdoor play. Falls onto an outstretched hand are a frequent cause, often resulting in a fracture near the wrist. Prompt recognition and appropriate treatment are important to ensure proper healing and long-term function.
What is a Distal Radius Fracture?
A distal radius fracture refers to a break near the wrist end of the radius bone in the forearm. In children, this area contains growth plates—zones of developing cartilage that guide bone growth. Fractures near these plates require careful monitoring, as improper healing can affect future growth.
Two types of fractures commonly seen in children are:
Buckle (or torus) fractures: The bone compresses on one side, causing a bulge instead of a full break. These are stable injuries and often heal with minimal treatment.
Greenstick fractures: The bone bends and partially breaks, similar to how a young twig snaps. These also tend to heal well with conservative care.
How Are Distal Radius Fractures Diagnosed?
Timely diagnosis supports proper healing and reduces the risk of complications.
Physical examination: Helps identify swelling, tenderness, or deformity in the wrist. A hand surgeon would check finger movement and blood flow to ensure circulation is intact.
X-rays: High-quality radiographs are arranged promptly to confirm the fracture type, assess alignment, and check for growth plate involvement—a key concern in paediatric injuries.
MRI or CT scans: Advanced imaging such as MRI or CT may be ordered for detailed assessment, especially if there is suspected ligament injury or if the fracture is comminuted and involves the joint surface or growth plate.
Treatment Options
Treatment approaches for distal radius fractures in children are tailored to the specific fracture type, its severity, and the child’s age and activity level.
Non-Surgical Treatment
Casting and Splinting: Stable fractures such as buckle (torus) or greenstick types are managed with a cast or splint. Immobilisation typically lasts 4–6 weeks and is accompanied by scheduled follow-up X-rays.
Closed Reduction: If the fractured bones are only mildly out of alignment, a procedure called closed reduction is performed. In this procedure, the bones are manually realigned, and then a cast or splint is applied to maintain the correct alignment as the fracture heals.
Surgical Treatment
Minimally Invasive Fixation: In cases of unstable, significantly displaced, or growth plate-involved fractures, the hand surgeon may recommend surgical fixation using K-wires, small plates, or screws to stabilise the bones. These procedures are performed with precision to protect growth potential and restore wrist function.
Follow-Up Care
Growth Plate Follow-up: For fractures involving the physis (growth plate), long-term monitoring with X-rays will be arranged to ensure the wrist develops normally over time.
Comprehensive Aftercare: Follow-up visits are typically scheduled at 1–2 week intervals initially, with continued reviews based on healing progression.
Recovery Process
The recovery timeline for distal radius fractures varies by individual case and care.
Healing time: Differs by age—younger children generally heal more quickly than teenagers. Many fractures heal within 4-6 weeks.
Possible Complications from a Distal Radius Fracture
While many children recover without issues, a hand surgeon would monitor for:
Growth concerns: Can occur if the fracture affects the growth plate. Long-term follow-up may be needed.
Malunion: Refers to the bone healing in a misaligned position. Minor cases often correct naturally in young children, but more significant issues might need further care.
Joint stiffness: This is common after cast removal but usually improves with regular movement. If it persists, your hand surgeon may advise further evaluation or guided mobility exercises.
Home Care Considerations
Parents can support their child’s comfort during recovery through:
Pain relief : This can be managed with paracetamol or other child-safe medications. Administer only medications prescribed or recommended by your child’s hand surgeon.
Cast care: It is important to keep the cast dry and clean. Options include waterproof covers for bathing or sponge baths for younger children.
Activity adjustment: This helps children stay active while protecting the healing bone. Encourage gentle activities and follow the hand surgeon’s advice on when to resume sports or active play.
When to Seek Medical Attention
Seek medical attention promptly if you notice:
Increased pain: Not relieved by recommended pain medicine
Numbness or tingling: These sensations in the fingers could suggest the cast is too tight or nerve compression.
Skin changes: Unusual paleness, blueness, or excessive swelling of the fingers indicate circulation problems requiring immediate attention.
Conclusion
Distal radius fractures are among the most common injuries in children but usually heal well with specialist care from a trained hand surgeon. Prompt diagnosis, proper immobilisation, and follow-up help ensure a smooth recovery and protect bone growth.
FAQs
Can a distal radius fracture cause long-term wrist weakness or instability?
Most cases heal without long-term effects. However, fractures involving the joint surface or growth plate may lead to reduced strength or range of motion if not properly treated and monitored. Associated ligament injuries can also result in wrist instability, affecting performance in sports.
How is the decision made between casting and surgery?
Treatment depends on bony alignment, fracture stability, involvement of the growth plate, and the child’s age. Surgery is considered if closed reduction does not maintain proper alignment.
Are children more likely to fracture the same wrist again?
The risk of re-injury exists, particularly if bone strength is low or the child resumes high-impact activities too soon. Proper rehabilitation and gradual return to sports should follow your hand surgeon’s guidance after full healing.
Are dietary supplements needed for fracture healing?
A balanced diet rich in calcium and vitamin D supports bone healing. Supplements may be recommended if dietary intake is inadequate or if the child has a nutritional deficiency.
