Treatment of Transverse Radial Metaphyseal Fracture

Initial Assessment and Classification

The American Academy of Orthopaedic Surgeons recommends careful evaluation of displacement, joint congruity, and stability to determine optimal treatment approach 2
Fractures are classified as significantly displaced when there is >3mm displacement or >10° dorsal tilt 2
Radiographic evaluation, including true lateral views, is necessary to assess alignment and potential DRUJ involvement 1, 3

The American Academy of Orthopaedic Surgeons recommends removable splints as an appropriate option for minimally displaced fractures 1
Active finger motion exercises should be initiated immediately following diagnosis to prevent stiffness 4
Rigid immobilization is preferred over removable splints for displaced fractures 1

A home exercise program is an effective option for patients prescribed therapy after fracture treatment 4
Active finger motion exercises should be performed following diagnosis to prevent stiffness, which is one of the most functionally disabling adverse effects 4
All patients with unremitting pain during follow-up should be reevaluated to identify potential complications 4

Hand stiffness can result from pain, swelling, splint/cast obstruction, or patient apprehension 4
Finger stiffness can be difficult to treat after fracture healing, potentially requiring multiple therapy visits and additional surgical intervention 4
Loss of alignment is a common complication, particularly in displaced fractures treated without adequate fixation 1
DRUJ instability may occur with distal radius fractures and should be assessed with a true lateral radiograph 4