Radius fracture (broken spoke)

A Radius fracture or a Broken spoke is a break in the spoke, which usually occurs near the wrist. It is one of the most common fractures and is in many cases the result of a fall in which the person tried to catch himself with his hand.

What is a radius fracture?

The Radius fracture represents a forearm fracture. Only one of the two forearm bones is affected, which is also called the radius or spoke. The spoke is located on the inside of the arm and carries the carpal bones and the hand.

It usually breaks near the wrist and is the result of an accident. Depending on the type of accident, the radius fracture is differentiated into different forms. The distal radius fracture is the most common. It occurs when the victim falls on the outstretched hand. This type of fracture with a characteristic break point is also known as an extension fracture or Colles' fracture.

In rare cases, a distal radius fracture occurs when falling on the flexed hand. Such a form of radius fracture is called a flexion fracture or a Smith fracture.

causes

The typical cause of a Radius fracture is a fall on the arm or hand. In most cases, there is a break near the wrist.

A fall on the palm of the hand outstretched occurred with a share of 90%. Children and the elderly in particular suffer from this type of forearm hernia. Different causes are responsible for this. Children often fall while playing and are therefore prone to fracture the radius. Older people, on the other hand, have a lower stability of the bones, so that a fall generally leads to broken bones more quickly.

Osteoporosis, which often occurs in old age, also has a beneficial effect. Other typical age-related diseases can also provoke falls, which in this way become the cause of a radius fracture.

Symptoms, ailments & signs

A fracture of the spoke is always associated with very clear and typical symptoms that the person concerned can diagnose himself very well. Immediately after the fracture, there will be severe and long-lasting pain that will persist even when the patient is at rest. Often there is also severe swelling that can be seen with the naked eye.

In addition, if there is a broken spoke, a misalignment of the wrist can often be seen. Even the smallest movements cause severe pain, so that normal movement is no longer possible. If you visit a doctor immediately at this point, you can quickly eliminate the existing symptoms and complaints.

However, if you forego medical and drug treatment at this point, you must expect further complaints and symptoms that can arise as a result. Inflammation is possible, causing an abscess to form. It develops within the structure of pus, which under certain circumstances can lead to blood poisoning.

However, if you decide to seek medical treatment at an early stage, you will notice an improvement within a short time. A fracture of the spoke is usually associated with painful symptoms that definitely require medical attention.

Diagnosis & course

Is there any suspicion Radius fracture, the doctor will first perform a visual diagnosis. The forearm is searched for potential skin injuries and damage to the nerves and vessels. The doctor also examines the adjacent joints so that any accompanying dislocation is not overlooked.

This is followed by an X-ray examination to determine the type of fracture. The wrist is recorded from the side and front. In order to find the optimal form of therapy, it is also diagnosed whether it is a stable fracture or an unstable fracture. The latter type of break involves injury to the ligaments.

How the radius fracture develops depends largely on the extent of the fracture. In children, a broken spoke usually heals relatively quickly. In the elderly or with a complicated form of radius fracture, the healing process can take longer than six months.

Complications

A radius fracture can have a number of complications. These can even show up during therapy. One of the most common sequelae of a broken spoke is the displacement of the broken bone. The fragments shift due to involuntary muscle tension, even if the patient is wearing a cast.

For this reason, regular x-rays are taken for control purposes. If another misalignment is discovered in the process, surgical intervention is usually necessary to correct it. Subsequent shifts of the radius fracture occur in around 50 percent of all patients with conservative therapy, which is a relatively high proportion. If these shifts appear several times in a row, doctors speak of Sudeck dystrophy.

Their characteristic features include a disruption of metabolism and blood flow to the bones and soft tissues. In most cases, Sudeck's dystrophy occurs after surgery, accidents, nerve damage, and infections. Older women are particularly affected.

Another consequence of a broken spoke is lesions on the nerves and blood vessels of the affected bone. The same applies to the skin and muscles. This means that bones and soft tissues can no longer be supplied smoothly, which leads to functional disorders. The complication becomes noticeable through permanent pain when hand movements and skin discoloration.

In the later stages, the hand stiffens and sensory disturbances appear. Complications are also possible with surgical treatment of the radius fracture. These include infections, restricted mobility, impaired wound healing and tendon injuries.

When should you go to the doctor?

If persistent pain is felt in the wrist after a fall, accident or violence, a doctor is required. It is characterized by a sudden, strong sensation of pain that occurs immediately after a triggering event. Since there is no spontaneous healing, medical care is required.

Consult a doctor in the event of swelling, discoloration of the skin or open wounds on the wrist. Circulatory disorders, a loss of the usual range of motion and a decrease in the physical capacity of the hand are further signs that must be clarified. With a radius fracture, the usual hand movements such as waving or tilting can no longer be performed. In addition, the gripping function of the hand and fingers can no longer be implemented or only with a severe restriction.

Numbness of the skin or impaired sensation are causes for concern. If light touches or a resting position lead to pain development, a doctor should be consulted. Before taking pain medication, you should always consult a doctor. Sterile wound care is required so that no pathogens can enter the organism. If there is a pus formation, an abscess or an inflammatory reaction of the skin, a doctor must be consulted immediately. Otherwise there is a risk of blood poisoning and thus a life-threatening condition.

Treatment & Therapy

The form of treatment a Radius fracture depends on the extent of the break. If it is a simple variant, the arm is immobilized with a plaster cast for several weeks. If the x-ray shows a shift in the bones, the doctor first sets up a device and then the arm is put in a cast.

If the hernia is threatened to move again or if it is not possible to set it up, surgery is recommended. The doctor brings the bone fragments back into their correct position. Then these must be stabilized. Different methods are available for this, depending on the radius fracture. The wire fixation, the external fixator, the screw connection and the metal plate implantation exist.

Which type of surgery is chosen depends on the degree of displacement of the bone fragments and the number of fractures on the forearm. It is also decisive whether the stylus extension of the spoke has broken off. An operation on the forearm is usually followed by a plaster cast. A radius fracture may require a second operation because the pieces of bone sometimes move unnaturally as the healing process takes place.

prevention

The most effective protection against a Radius fracture or a Broken spoke is avoiding falls. Anyone who practices high-risk sports such as inline skating should not do without adequate protective clothing. It is also important to recognize any osteoporosis at an early stage. In this way, bone loss can be treated effectively, which also prevents a radius fracture.

Aftercare

Follow-up treatment of the radius fracture takes place with both conservative therapy and surgical intervention. For this purpose, the patient is given a plaster cast for about four to six weeks to keep the affected arm still. In the case of an operation, immobilization may also take less time.

As part of the aftercare, the plaster cast is changed at regular intervals. The fingers usually remain freely movable within the bandage. Post-operative pain in the wrist is possible following a radius fracture operation. The patient should therefore be treated as an inpatient for about two nights. The surgical threads can usually be removed after around 10 to 14 days.

After surgery, the patient is given thrombosis prophylaxis while they are in the hospital. After discharge from the clinic, the administration of the medication can usually be stopped again. In addition, it is possible to administer drugs that relieve pain and reduce swelling.

Another important part of the follow-up treatment are physical and occupational rehabilitation measures. Movement exercises for thumb and fingers are also carried out. Active mobilization of the shoulder and elbow joint after prolonged immobilization is also useful. At the same time, attention is paid to smooth circulation and sensitivity of all fingers. After two to three weeks, the patient can return to everyday activities. After eight to twelve weeks, sporting activities are usually also possible.

You can do that yourself

Although a broken spoke is common, it should not be treated carelessly. Those affected should see a doctor immediately so that he can treat the hernia properly. Complicated and severe fractures in particular can lead to functional impairments if they heal poorly. This is especially true when the wrist is involved.

In addition to being painful, breaking the spoke can lead to inflammation, which can lead to abscesses and blood poisoning. It is therefore advisable to take anti-inflammatory pain relievers or non-steroidal anti-inflammatory drugs (NSAIDs). Here the doctor will issue appropriate prescriptions. A radius fracture also injures the tissue around the fracture site, which can lead to swelling. This swelling can be cooled by the plaster cast. Medical cooling compresses that are placed on the bandage are recommended. If the cooling pads have been stored in the freezer compartment, they should never be placed directly on the skin, as this can cause cold burns.

It may take a few weeks for the arm to be fully functional again. Patience is required during this time. The affected arm should be immobilized for as long as possible. This promotes healing and significantly reduces the complication rate. When the cast has been removed, the patients should definitely perform the physiotherapy prescribed for them. It promotes mobility of the affected arm and helps heal the fracture completely.