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Distal Radius Fracture
Kambiz Motamedi, MD, FACR; Carol L. Andrews, MD
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KEY FACTS

  • Terminology

    • Diagnostic Checklist

      TERMINOLOGY

      • Synonyms

        • Smith fracture = reverse Colles fracture
        • Chauffeur's fracture = Hutchinson fracture
      • Definitions

        • Colles: transverse metaphyseal fracture with dorsal angulation ± displacement
        • Smith: transverse metaphyseal fracture with volar angulation ± displacement
        • Barton: dorsal lip (articular margin) intraarticular fracture
        • Reverse Barton: volar lip intraarticular fracture
        • Chauffeur's: oblique intraarticular radial styloid fracture
        • Complex intraarticular fracture: 3 major intraarticular fragments, often with angulation
        • Die-punch: lunate fossa impaction fracture
        • Traumatic osteolysis: irregular lysis of distal metaphysis adjacent to growth plate

      IMAGING

      • Radiographic Findings

        • Imaging Recommendations

          PATHOLOGY

          • General Features

            • Staging, Grading, & Classification

              CLINICAL ISSUES

              • Presentation

                • Demographics

                  • Natural History & Prognosis

                    • Treatment

                      DIAGNOSTIC CHECKLIST

                      • Consider

                        • Image Interpretation Pearls

                          • Reporting Tips

                            Selected References

                            1. Quadlbauer S et al: Current management of distal radius fractures and their complications. Arch Orthop Trauma Surg. 140(5):593-4, 2020
                            2. Porrino JA Jr et al: Fracture of the distal radius: epidemiology and premanagement radiographic characterization. AJR Am J Roentgenol. 203(3):551-9, 2014
                            3. Belloti JC et al: The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius - description and reproducibility. Sao Paulo Med J. 131(4):252-6, 2013
                            4. Fallahi F et al: Explorative study of the sensitivity and specificity of the pronator quadratus fat pad sign as a predictor of subtle wrist fractures. Skeletal Radiol. 42(2):249-53, 2013
                            5. Randsborg PH et al: Fractures in children: epidemiology and activity-specific fracture rates. J Bone Joint Surg Am. 95(7):e421-7, 2013
                            6. Clayton RA et al: Association between decreased bone mineral density and severity of distal radial fractures. J Bone Joint Surg Am. 91(3):613-9, 2009
                            7. Belloti JC et al: Are distal radius fracture classifications reproducible? Intra and interobserver agreement. Sao Paulo Med J. 126(3):180-5, 2008
                            8. Makhni EC et al: Effect of patient age on the radiographic outcomes of distal radius fractures subject to nonoperative treatment. J Hand Surg Am. 33(8):1301-8, 2008
                            9. Mackenney PJ et al: Prediction of instability in distal radial fractures. J Bone Joint Surg Am. 88(9):1944-51, 2006
                            10. Karnezis IA et al: Correlation between radiological parameters and patient-rated wrist dysfunction following fractures of the distal radius. Injury. 36(12):1435-9, 2005
                            11. Andersen DJ et al: Classification of distal radius fractures: an analysis of interobserver reliability and intraobserver reproducibility. J Hand Surg Am. 21(4):574-82, 1996
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Diagnostic Checklist

                                TERMINOLOGY

                                • Synonyms

                                  • Smith fracture = reverse Colles fracture
                                  • Chauffeur's fracture = Hutchinson fracture
                                • Definitions

                                  • Colles: transverse metaphyseal fracture with dorsal angulation ± displacement
                                  • Smith: transverse metaphyseal fracture with volar angulation ± displacement
                                  • Barton: dorsal lip (articular margin) intraarticular fracture
                                  • Reverse Barton: volar lip intraarticular fracture
                                  • Chauffeur's: oblique intraarticular radial styloid fracture
                                  • Complex intraarticular fracture: 3 major intraarticular fragments, often with angulation
                                  • Die-punch: lunate fossa impaction fracture
                                  • Traumatic osteolysis: irregular lysis of distal metaphysis adjacent to growth plate

                                IMAGING

                                • Radiographic Findings

                                  • Imaging Recommendations

                                    PATHOLOGY

                                    • General Features

                                      • Staging, Grading, & Classification

                                        CLINICAL ISSUES

                                        • Presentation

                                          • Demographics

                                            • Natural History & Prognosis

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Consider

                                                  • Image Interpretation Pearls

                                                    • Reporting Tips

                                                      Selected References

                                                      1. Quadlbauer S et al: Current management of distal radius fractures and their complications. Arch Orthop Trauma Surg. 140(5):593-4, 2020
                                                      2. Porrino JA Jr et al: Fracture of the distal radius: epidemiology and premanagement radiographic characterization. AJR Am J Roentgenol. 203(3):551-9, 2014
                                                      3. Belloti JC et al: The IDEAL classification system: a new method for classifying fractures of the distal extremity of the radius - description and reproducibility. Sao Paulo Med J. 131(4):252-6, 2013
                                                      4. Fallahi F et al: Explorative study of the sensitivity and specificity of the pronator quadratus fat pad sign as a predictor of subtle wrist fractures. Skeletal Radiol. 42(2):249-53, 2013
                                                      5. Randsborg PH et al: Fractures in children: epidemiology and activity-specific fracture rates. J Bone Joint Surg Am. 95(7):e421-7, 2013
                                                      6. Clayton RA et al: Association between decreased bone mineral density and severity of distal radial fractures. J Bone Joint Surg Am. 91(3):613-9, 2009
                                                      7. Belloti JC et al: Are distal radius fracture classifications reproducible? Intra and interobserver agreement. Sao Paulo Med J. 126(3):180-5, 2008
                                                      8. Makhni EC et al: Effect of patient age on the radiographic outcomes of distal radius fractures subject to nonoperative treatment. J Hand Surg Am. 33(8):1301-8, 2008
                                                      9. Mackenney PJ et al: Prediction of instability in distal radial fractures. J Bone Joint Surg Am. 88(9):1944-51, 2006
                                                      10. Karnezis IA et al: Correlation between radiological parameters and patient-rated wrist dysfunction following fractures of the distal radius. Injury. 36(12):1435-9, 2005
                                                      11. Andersen DJ et al: Classification of distal radius fractures: an analysis of interobserver reliability and intraobserver reproducibility. J Hand Surg Am. 21(4):574-82, 1996