Symptoms and complaints

To the physician, the classic picture of a distal radius fracture (commercial fracture) is as follows: The affected wrist is presented by the patient in a relieving posture, an independent movement in the wrist no longer takes place (Funktio laesa). On closer examination, the wrist is swollen and, in the case of a very displaced injury, there is a bayonet malposition of the wrist, i.e. the fracture of the radius near the wrist has shifted towards the back of the hand and simultaneously towards the spokes, thus impressing the typical image of a bayonet position of the forearm. Sensitive pressure pain can be triggered via the fracture. Any attempt to move the wrist is perceived as extremely painful, and often friction sounds of the broken bone can be produced (crepitations).

Swelling
Pain, partly pain in the scaphoid
Malposition (this allows conclusions to be drawn about the injury mechanism and severity)
Function restriction (Funktio laesa) = restricted mobility

Duration

Depending on the form of therapy, a different healing period can be expected: before each therapy, the broken pieces of bone must be returned to their original position. In order to reposition the fragments, a local anaesthetic is injected into the fracture gap. Then the original position is restored by pulling on the fingers and counter pulling on the arm.If the fragments are not displaced, a cast can be applied directly to stabilize the fracture for at least six weeks.

Since the fracture can subsequently shift, the position of the fracture must be checked in regular X-ray examinations. To avoid stiffening, finger and muscle exercises should be performed despite immobilization. If the fracture is shifted, operations are necessary, which vary according to the degree of shifting: If the spoke fracture is only slightly displaced and the joint is not involved, larding wires (Kirschner wires) are sufficient for stabilization.

Once the fracture has been set up, they are fixed in the bone via small skin incisions. This can be performed on an outpatient basis. The spoke fracture must then be splinted with a plaster cast for at least six weeks.

Subsequent displacement cannot be ruled out here either. At the end of the six weeks, the wires are removed under local anesthesia. If the spoke fracture is unstable or the joint is also affected, so-called plate osteosyntheses are performed.

These are small metal plates that are attached to the bone with nails or screws. In the case of a spoke fracture, this plate is mainly attached on the flexor side. Irritation of the tendons is more common with metal plates on the extensor side, which is why the extensor side position is avoided.

The plating allows the arm to be moved again at an early stage and a stiffening or muscle loss can be counteracted by physiotherapy. This is also known as exercise stability. Removal of the plates is not necessary and the patient can be spared a further painful treatment.