Radial Fractures and Associated Nerve Involvement

Clinical Presentation and Diagnostic Considerations

Distal radius fractures commonly present with pain that may extend beyond the immediate fracture site into the hand and ulnar side of the wrist due to associated soft tissue injuries, edema, and potential nerve involvement, as recommended by the American College of Radiology 1
Standard radiographic evaluation of suspected distal radius fractures should include a 3-view examination: posteroanterior (PA), lateral, and 45° semipronated oblique views, according to the American College of Radiology 1
When initial radiographs are negative but clinical suspicion remains high, additional imaging such as CT may be necessary to identify occult fractures, as suggested by the American College of Radiology 1
All patients with distal radius fractures should receive a postreduction true lateral radiograph of the carpus to assess distal radioulnar joint (DRUJ) alignment, as recommended by the American Academy of Orthopaedic Surgeons 2

Unremitting pain during follow-up of distal radius fractures warrants reevaluation, as this may indicate nerve compression, DRUJ instability, or other complications, according to the American Academy of Orthopaedic Surgeons 3