![]() The majority (64%) of these fractures occur in males, primarily in the spring. During these times the rate of bone lengthening exceeds the rate of mineralization, which leaves these children more susceptible to fracture with even minor trauma. These peaks relate to the decreased level of skeletal mineralization and density that exist during pubertal growth spurts. In children, the peak incidence of DR fractures is 12-14 years old in boys and 10-12 years old in girls. The two most common age groups are children less than 18 years old, and adults greater than 50 years old. However, there is largely a bimodal distribution of these injuries based on age and sex. It is also possible that increased access to care has led to an apparent increase in fractures while the true incidence has remained stable.ĭR fractures can occur at any age. Another theory advanced is that increased participation in organized sports has led to more childhood DR fractures. ![]() However, the general thinking is that increased childhood obesity and the overall potential for people to live more years with comorbidities such as osteoporosis have primarily contributed to this problem. It is difficult to attribute the growing incidence of DR fractures to any single cause. This study also showed statistically significant increases for the 17-64 year age group. Another 2017 study by Jerrhag et al., from Sweden showed a 2.0% increase in DR fractures per annum in men and a 3.4% increase in women aged 50-59 between 1999-2010. For example, a 1998 study by Melton et al., from Rochester, Minnesota in the United States documented a 17% increase in DR fractures between 1945-1994. The overall incidence of DR fractures occurring each year is increasing worldwide. With the exception of the 18 to 34-year-old age group, DR fractures are the most common upper extremity fracture. Distal radial and ulnar fractures account for approximately 25% of these fractures. For example, in the United States, there is an incidence of around 67 upper extremity fractures per 10,000 people annually. The mechanism for these fractures is often more complex or atypical than that of isolated DR fractures.ĭistal radial fractures are very common either in isolation or in concert with other fractures and injuries. DR fractures can also present in more complicated injury patterns such as the Galeazzi fracture-dislocation, both bone fractures, radial styloid fractures, and Barton’s and Chauffeur’s fractures. In children and adolescents, isolated DR fractures are more frequently the result of high energy falls sustained on the playground or during sporting events. They are often comminuted and intra-articular fractures that often fall outside of traditional eponymous classification. DR fractures in the elderly are often the result of low-energy falls from a standing or seated position. These fractures most frequently occur as a result of fall on the outstretched hand (FOOSH) injuries. ![]() Isolated DR fractures typically include Smith’s, Colle’s, Torus/Buckle, Greenstick, Die-punch, and isolated radial shaft fractures. This chapter will review the epidemiology/etiology, as well as the eponymous fractures, management, and complications of distal radial fractures.ĭistal radial fractures can result from any trauma to the forearm. Providers must have an understanding of forearm and wrist anatomy, and the recommendation here is that that readers review this topic in conjunction with this article. It is crucial for providers to understand these distinctions, to know which fracture patterns are emergent, and to refer for further management in an appropriate time frame. Fracture patterns, management, and complications differ between these age groups. ![]() ![]() Distal radial fractures are seen predominantly in children/adolescents and the elderly. The incidence of radial fractures is increasing as life expectancy grows, leading to a larger population of patients who are at risk for these injuries. Fractures involving the distal radius (DR) of the forearm are common. It is essential for most providers to feel confident in the management of fundamental orthopedic problems. Emergency Department and primary care clinics are frequently called on to evaluate orthopedic complaints. ![]()
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