Distal radius fracture non-operative treatment
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
Non-Operative Treatment
Where the fracture is undisplaced and stable, non operative treatment involves splinting the fracture, often in a cast. In displaced fractures, the fracture may be manipulated under regional or general anaesthesia and casted in a position to minimize the risk of re-displacement. The general principle is to reverse the mechanism of injury. A FOOSH will usually cause over-extension of the wrist joint, often with some radial deviation. Therefore, the preferred position for this type of injury, following reduction, is flexion and ulnar deviation.
During the period of follow-up, it is common practice to repeat x-rays at about 1 week to make sure the position is still acceptable. Follow-up is also needed to determine when the cast may be removed, when the fracture has healed and when rehabilitation is complete.
The length of time in the cast varies with different ages. Children heal more rapidly, but may ignore activity restrictions. Three weeks in a cast and 6 weeks off sports is often appropriate for them. In adults, the risk of stiffness of the joint increases the longer it is immobilised. If callus is seen on x-ray at 3 weeks, the cast may be replaced by a removable splint. However, many orthopaedic surgeons leave the patients in the cast for up to 6 weeks.
Following healing and cast removal a period of rehabilitation for recovery of strength and range of motion is necessary.