Distal Radius Fracture: The Most Common Wrist Fracture in Seniors

A distal radius fracture — a break at the lower end of the radius bone, just above the wrist — is the most common wrist fracture in older adults, accounting for nearly one in six fractures seen in emergency settings. 

At Sancheti Hospital, Pune, our orthopedic specialists treat this injury regularly, particularly in patients above 60. With the right diagnosis and timely care, most seniors recover full wrist function and return to their daily activities.

What Is a Distal Radius Fracture?

The radius is one of the two long bones in the forearm, and its “distal” end is the part closest to the wrist. When this section breaks — typically from a fall on an outstretched hand — it is called a distal radius fracture. The most well-known type is the Colles’ fracture, where the broken bone fragment tilts backward, giving the wrist a distinctive “dinner fork” appearance.

Other types include the Smith’s fracture (the fragment tilts forward) and intra-articular fractures, which extend into the wrist joint itself and tend to be more complex.

Why Are Seniors More Vulnerable?

Older adults are disproportionately affected by this injury for two key reasons. First, age-related bone loss — particularly from osteoporosis — makes the radius more brittle and susceptible to breaking even from a low-impact fall. Second, balance and coordination naturally decline with age, making falls more frequent.

Women past menopause face the highest risk because hormonal changes accelerate bone density loss significantly. At Sancheti Hospital, we always assess underlying bone health as part of our fracture management plan, because treating only the fracture without addressing osteoporosis can lead to repeat injuries.

Common Causes and Situations to Watch For

The most typical cause is a fall on an outstretched hand (FOOSH injury) — a natural reflex when someone trips or stumbles. Common scenarios include:

• Slipping on wet floors or uneven surfaces
• Tripping over steps, rugs, or footwear
• Falls from low furniture or during bathing
• Minor road accidents or sudden loss of balance

Recognising the Symptoms

Prompt recognition helps in seeking early treatment. Typical signs of a distal radius fracture include:

• Sudden, sharp pain at the wrist immediately after a fall
• Visible swelling and bruising around the wrist joint
• Tenderness on touching the wrist or forearm
• Deformity or abnormal appearance of the wrist
• Difficulty or inability to move the wrist and fingers
• Numbness or tingling, which may suggest nerve involvement

How Is a Distal Radius Fracture Diagnosed?

At Sancheti Hospital, our orthopedic team begins with a thorough clinical examination to assess swelling, tenderness, and alignment. This is followed by:

X-rays — the primary diagnostic tool, which reveal the fracture pattern, displacement, and alignment

CT scan — recommended for complex or intra-articular fractures to plan treatment precisely

Bone density scan (DEXA) — especially in postmenopausal women, to evaluate for underlying osteoporosis.

Treatment Options: From Casting to Surgery

Treatment depends on the type of fracture, degree of displacement, and the patient’s overall health and activity level.

Non-Surgical Treatment

For stable, minimally displaced fractures, conservative management works well. This typically involves:

• Closed reduction — the doctor gently realigns the broken bone without surgery
• Plaster cast or splint — worn for 4 to 6 weeks to hold the bone in position while it heals
• Regular follow-up X-rays to monitor alignment during healing

Surgical Treatment

When the fracture is unstable, severely displaced, or involves the wrist joint surface, surgery may be necessary. Common surgical approaches include:

• Volar locking plate fixation — the most widely used technique, where a metal plate and screws are attached to the bone to hold fragments in place
• External fixation — used in specific cases, especially with significant soft tissue injury
• Percutaneous pinning — involves placing small wires through the skin to stabilise the fracture

At Sancheti Hospital, our surgical team uses advanced fixation techniques to help patients regain wrist strength and mobility as early as possible.

Recovery and Rehabilitation: What to Expect

Recovery from a distal radius fracture in seniors takes time and patience. General milestones include:

• Weeks 1–2: Swelling and pain management; fingers gently exercised
• Weeks 3–6: Cast or splint in place; gradual monitoring of bone healing
• After cast removal: Physiotherapy begins to restore wrist movement and grip strength
• 3–6 months: Most patients regain functional use of the wrist, though complete recovery can take up to a year

Physiotherapy is an essential part of recovery. Our rehabilitation team at Sancheti Hospital works closely with patients to design personalised exercise programs that restore flexibility, reduce stiffness, and rebuild strength.

Complications to Be Aware Of

While most distal radius fractures heal well, some complications can arise, particularly when treatment is delayed or in the presence of severe osteoporosis:

• Malunion — fracture healing in a poor position, causing wrist deformity or restricted movement
• Post-traumatic wrist arthritis — especially with joint-surface fractures
• Carpal tunnel syndrome — due to nerve compression from swelling
• Reflex sympathetic dystrophy (CRPS) — a chronic pain condition affecting the hand and arm
• Stiffness and reduced grip strength — without adequate physiotherapy

Preventing Wrist Fractures in Older Adults

Prevention is always better than cure. At Sancheti Hospital, we encourage seniors and their caregivers to take proactive steps:

• Bone health first: Get regular DEXA scans; manage osteoporosis with calcium, Vitamin D, and prescribed medications if needed
• Fall-proof your home: Remove loose rugs, improve lighting, install grab bars in bathrooms
• Footwear matters: Always wear well-fitted, non-slip footwear indoors and outdoors
• Stay active: Weight-bearing exercises and balance training (such as yoga or Tai Chi) strengthen bones and reduce fall risk
• Annual health check: Discuss fall risk assessment and bone density with your orthopedic specialist

When to See an Orthopedic Specialist in Pune

Do not ignore a wrist injury after a fall, especially if you are above 60 or have known osteoporosis. Early evaluation at a specialised orthopedic centre like Sancheti Hospital ensures accurate diagnosis, appropriate treatment, and a well-guided recovery plan. Delayed or inadequate treatment of distal radius fractures can lead to long-term wrist pain, stiffness, and functional limitations that significantly impact quality of life.

Key Takeaways

• A distal radius fracture is the most common wrist fracture in seniors, most often caused by a fall on an outstretched hand.
• Osteoporosis significantly increases the risk, particularly in postmenopausal women.
• Treatment ranges from casting to surgical fixation with locking plates, depending on fracture severity.
• Physiotherapy after healing is crucial for restoring full wrist function and grip strength.
• Preventing falls and managing bone density are the most effective long-term strategies.
• At Sancheti Hospital, Pune, our orthopedic team provides comprehensive fracture care — from diagnosis to rehabilitation — tailored to each patient’s needs.