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Overview
As the name implies, this condition involves the radius breaking at the distal end of the bone by the wrist
It is a "catch all term" for any fracture of the radius that is close to the wrist
Most often occurs from falling on an outstretched hand
More common in children/adolescents and in older adults
Most Common Types of Fractures
Colle's:
Most common type (90% of all distal radius fractures)
Broken piece of the radius tilts dorsally
Can involve an avulsion fracture of the ulnar styloid (ulnar styloid gets pulled and broken by a ligament of the TFCC during the trauma)
Caused by falling on an outstretched hand with the wrist in extension
Upon landing the wrist is forced into supination
Smith's:
Opposite of Colle's fracture
Broken piece of the radius tilts volarly
Caused by a fall or blow to the back of the hand with the wrist in flexion
Upon landing the wrist is forced into pronation
Greenstick and Buckle/Torus Fractures:
Both of these fractures are common in the pediatric population
Are incomplete fractures due to pediatric bones being softer and they can bend without fully breaking
Due to pediatric bones having less minerals
Greenstick fractures are caused by bending forces
One side of the bone breaks (convex/outer side)
Other side of the bone bends but doesn't break
It is like bending a green stick where one side one side cracks and the other side gets bent
Buckle/Torus fractures are caused by a force straight down the bone
Instead of cracking, the bone compresses and buckles inward, kind of like a dented soda can
There is no crack or break line, but just a bulge where the bone got squished
Chaigasame, O. (2025). Colles Fracture Versus Smith Fracture. In Colles Fracture. StatPearls Publishing LLC. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK553071/figure/article-19715.image.f3/
Further Classification of Fractures
Closed fracture vs Open fracture:
Closed fracture does not break through the skin
Open fracture involves the bone breaking through the skin and has the risk of infection
Extra-articular vs intra-articular:
Extra-articular fractures do not involve the joint surface
Intra-articular fractures involve the joint surface and may lead to joint complications (usually the radiocarpal joint)
Comminuted:
Fractures where the bone is broken into multiple pieces
Usually requires surgical fixation using hardware such as screws and plates
American Academy of Orthopaedic Surgeons (AAOS). (n.d.). Distal Radius Fractures (Broken Wrist). Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/distal-radius-fractures-broken-wrist/
Symptoms (once out of cast or orthosis)
Pain
Decreased range of motion and stiffness in wrist and possibly fingers
Edema/swelling
Tenderness around fracture site
Weakness
Guarding of upper extremity due to fear of reinjury
Who Gets It?
Distal radius fractures can occur to anyone in a wide range of scenarios
More common in pediatric and geriatric populations
In children/adolescents it often occurs from high-energy falls such as at a playground or during sports
In elderly it often occurs from low-energy falls from either seated or standing
Prognosis/Timeline
Simple fractures are typically casted or in a custom orthosis for 4-6 weeks and then begin rehabilitation complex fractures that require open reduction internal fixation are usually in a custom orthosis for 1-2 weeks before beginning rehabilitation
Simple fractures have a great prognosis and usually return to full function (range of motion may be slightly less compared to other, non-broken wrist)Complex fractures have a slower recovery and there is a higher risk for functional limitations and reduced range of motion
Overall it can take up to a year to see full strength, endurance, and range of motion to return to their full potential
Treatment Ideas
Wrist AROM and progressive strengthening
Pronation and supination with hammer
Stretching and AROM
Quiz Questions
What is the most common type of distal radius fracture?
A. Smith’s fracture
B. Greenstick fracture
C. Colles’ fracture
D. Torus fracture
Which population is most likely to experience a buckle or greenstick fracture?
A. Elderly individuals
B. Adolescents
C. Middle-aged adults
D. Pediatric population
Which of the following describes a comminuted fracture?
A. Bone breaks into multiple pieces
B. Bone cracks but does not break completely
C. Involves the joint surface
D. Bone stays aligned
An intra-articular fracture involves which of the following?
A. Only the bone shaft
B. The bone and the surrounding muscle
C. The joint surface
D. The tendon sheath
What age groups are most commonly affected by distal radius fractures?
A. Middle-aged adults and older adults
B. Neonates and infants
C. Children/adolescents and older adults
D. Children/adolescents and middle-aged adults
How long might it take for full recovery of strength and range of motion after a distal radius fracture?
A. 2-4 weeks
B. 3 months
C. 6 months
D. Up to 1 year
During a Smith’s fracture, the distal radius fragment typically shifts in which direction?
A. Volar
B. Dorsal
C. Distal
D. Proximal
What wrist position at the time of injury is most likely to cause a Colles’ fracture?
A. Wrist in extension
B. Wrist in ulnar deviation
C. Wrist in neutral
D. Wrist in flexion
Quiz Answers
C
D
A
C
C
D
A
A
References
Corsino, C. B., Reeves, R. A., & Sieg, R. N. (2025). Distal radius fractures. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK536916/
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