![]() When the distal radius is bent backwards, a " dinner fork deformity" may be present. Sometimes a deformity is visible as well. Capillary refill (pinching the fingers to see if they quickly turn pink again) is checked to make sure that blood is making its way to the fingers. Sensation and strength of the fingers is often tested to ensure that nerves are intact. A thorough physical examination seeks not only to confirm that the distal radius has been broken, but also to rule out other injuries and ensure that nerves and vessels are intact. ྕ Fall on an outstretched arm (FOOSH) ྕ Traumatic sporting injury or motor vehicle accident ྕ Immediate pain and swelling Physical Exam Tenderness over the distal end of the radius is concerning for a distal radius fracture. Others will assume they have simply sprained the wrist and delay seeking care until pain persists for a day or two. Most people seek care at the emergency department the same day the injury occurs. The injury results in immediate pain and swelling. An elderly woman may report a simple trip and fall, while a young male may report a sporting injury or motor vehicle accident. The older and more brittle the bone, the less traumatic the injury has to be to break the wrist. Diagnosing and Evaluating Distal Radius Fractures History Distal radius fractures occur after a traumatic injury. This is known as a buckle fracture or a torus fracture. They may also break their wrists with a fall on an outstretched hand (FOOSH), but they tend to bend rather than completely snap the distal radius. Children have more flexible bones that are still developing and maturing. In this population, simply tripping and falling to the floor on an outstretched hand can result in a fracture of the distal radius. Hormonal changes result in less uptake of minerals needed for building strong bones. Older adults, especially females, have thinner, more brittle bones. And so distal radius fractures are not unusual among younger adult males. Young men are more commonly involved in motor vehicle accidents and sporting injuries. However, a more traumatic injury can break a stronger bone. In this population, a simple fall usually does not result in a broken wrist. Young, healthy adults have bones that are solid and strong. Fractures of the Distal Radius Fractures of the distal radius are very common because it is natural to extend the arm out to protect one's self during a fall or collision. Blood vessels are able to carry nutrients through the bone to keep it healthy. The outer layer of the bone is dense, rigid, and hard. When the wrist if bent forward, toward the palm of the hand, it is known as flexion, volar flexion, or palmar flexion. When the wrist is bent backward, away from the palm of the hand, it is known as extension or dorsiflexion. The back of the wrist, the side opposite the palm of the hand, is called the dorsal side. The front of the wrist, the side on the same side as the palm of the hand, is called the palmar side or the volar side. Two tendons, the brachioradialis and pronator quadratus, attach to the distal radius. Their tendons cross over the wrist joint. Most of the muscles that move the wrist and fingers are located in the forearm. Tendons are strong, fibrous structures that attach muscles to bones. Ligaments also hold the ulnar head to the distal radius to form the distal radioulnar joint (DRUJ). Several ligaments serve to hold the radius to the carpal bones. Bones are held together by fibrous bands known as ligaments. The distal radius forms a triangular tip called the radial styloid. The ulnar notch is formed on the side where the head of the ulna sits. The scaphoid bone sits in the scaphoid fossa and the lunate sits in the lunate fossa. The articular surface has two shallow valleys that provide places for two of the carpals to sit. The end of the radius where it meets the carpal bones and is capped with cartilage is known as the articular surface. Articular cartilage is slightly softer and more rubbery than bone. This lowers friction in the joint and allows the bones to glide smoothly against one another as the wrist moves. Articular cartilage is smooth and slippery. The cartilage that caps the ends of bones in joints is known as articular cartilage. The carpal bones are also capped with cartilage. The end of the radius is capped with a smooth, slippery layer of cartilage. The proximal radius is the part of the radius that meets the elbow. " Proximal" means the opposite-closer to the center of the body. The distal radius is the part of the radius that meets the wrist. ![]() ![]() " Distal" is a word that describes a body part as being farther away from the center of the body. The radius is located on the same side of the wrist as the thumb. The radius is larger at the wrist than the ulna. The wrist joint is formed where the two long bones of the forearm, the radius and ulna, meet the small carpal bones.
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