Sunday, April 18, 2021

Distal Radius Fracture Reduction

Distal Radius Fracture Reduction 
  1. Get X-RAY WRIST AP and Lateral View 


  2. ANAESTHESIA- (Sometimes people don’t give any anaesthesia, which should be avoided)

2 Options: 

A. Hematoma Block 

-Locate fracture site
-Under sterile prepration using 20G needle Pierce and go deep
-Pull back to confirm fracture site (you will get blood)
-Inject 5-6 cc 1% lidocaine
-Wait for 10-15 min


B. Sedation



  • Hold the hand of patient as if "shaking hand". Dis-impaction of fragment: (by traction and counter-traction) 

  • Palmar flexion and ulnar deviation pronation (see pic) 

(it may be necessary sometimes to accentuate the fracture while applying traction to free the fragments before pushing it into place) 



4)CAST is applied with moulding (contrary to normal rule of immobilizing one joint proximal and one joint distal, the elbow joint is spared here as generally the patients are elderly) 

(while applying cast continuous traction is given by the assistant by pulling from finger) 

 Three-point moulding of cast

-1 hand at fracture site
-Other distal to fracture site on opposite side of wrist
-Assistant hand is applied at elbow

5) X-RAY to confirm the reduction and correction of dorsal and lateral tilt 

Repeat x-ray every week for first 3 weeks to detect re-displacement.


Written by our guest author -Pratik Mundada
Illustration by Devi Bavishi


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