Radius fracture • The spoke breaks most often!

If we fall, we reflexively support ourselves with our hands. This often results in a fracture of the radius, also known as a broken spoke. While older people tend to fracture the radius after occasional falls, sports and cycling accidents are the most common causes of younger people.

Radius fractures are usually the result of falls, for example while cycling.
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No bone breaks more often than the spoke (radius). This break is called a radius fracture or a broken spoke. If the broken arm is near the wrist, it is known as a distal radius fracture.

The fall on the outstretched arm is the typical cause of accidents for a radius fracture. Together with the ulna, the spoke forms the skeleton of the forearm and part of the wrist. In many cases, a fracture also tears off the so-called stylus extension of the ulna. A radius fracture is also common in children.

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Symptoms of radius fracture

Severe pain immediately after the fall, which increases with movement or stress, and gradually increasing swelling as a result of the bruise are usually the first indications of a possible radius fracture.

Pain and swelling after a fall suggest a broken spoke. Sometimes the axis misalignment of the broken bones is also directly visible or a crunch can be heard when moving. In any case, no further strain should be placed on the injured wrist and the wrist should be kept calm and as high as possible until further treatment. This avoids unnecessary pain and prevents excessive swelling from developing.

The sooner medical treatment with X-rays is carried out, the better. This is the only way to make a reliable diagnosis.

A fall is usually the cause of a radius fracture

A radius fracture is usually the result of a fall. Due to the reduced bone density, older people are at risk of breaking their spokes even if they have harmless casual falls. In the case of children and younger adults, bicycle or sports accidents (for example inline skating or mountain biking) are the main causes of accidents.

X-ray confirms the diagnosis of the fracture of the radius

The doctor often recognizes the broken spoke by the existing misalignment. Nevertheless, an additional x-ray is required so that the position of the fragments in relation to one another can be assessed.

A fracture of the radius can be determined through a physical examination paired with an X-ray. Complicated forms of a broken spoke, such as a fragmentary break (break with several fragments) or a break that pulls into the joint surface, can also be recognized in this way.

Therapy: Radius fracture healed after about six weeks

If a radius fracture occurs, the affected bone must be immobilized, usually with a cast. The broken spoke requires a sufficiently long plaster treatment. It takes about five to six weeks for adults to heal completely.

Before plastering, it must be ensured that the bone fragments are in an anatomically correct axis to each other in order to avoid a subsequent malfunction of the wrist. It is therefore often necessary to straighten (reduce) the bones. Depending on the severity of the fracture, this is done with local anesthesia or by means of special anesthetic methods, for example anesthetic of the arm nerves (plexus analgesia). With the help of regular x-rays, the correct position of the bone fragments and the subsequent healing process are checked.

If the reduction is unsatisfactory or if the fracture is complicated with several fragments, surgical treatment may also be indicated.

There are basically two dressing materials available for conservative therapy:

  • the classic, white plaster, which can be modeled perfectly and hardens after drying. It is suitable for the entire duration of the treatment.

  • Plastic bandages are lighter and more stable, but at the same time significantly more expensive, not environmentally friendly and much more difficult to mold. They are therefore not used on fresh, still swollen fractures.

Follow-up treatment of a radius fracture

Fingers and elbows should be moved further in the cast to prevent later movement restrictions. As a result of being immobilized in the cast for several weeks, the first movements after the cast is removed are often somewhat painful. The range of motion and muscle strength can also be reduced initially after a radius fracture.

In individual cases, the wrist can be specifically trained through physiotherapeutic treatment. The bone itself is sufficiently firm after the plaster treatment and can be fully loaded again without fear.

The danger of a distal radius fracture (breakage of the spoke near the wrist) is that Sudeck's disease will occur as a result.

What you can do as a patient with a radius fracture

A fall is difficult to avoid in order to prevent a broken spoke. In an emergency, however, those affected can prevent complications:

  • Although the wrist is immobilized by the cast, the neighboring joints (fingers, elbows and shoulder) should be moved several times a day.

  • However, if there is swelling of your hand and fingers, for example, keep your arm still and elevate it.

  • Pain or numbness in the fingers is a red flag that could indicate an ill-fitting cast. In this case you should see a doctor immediately.