Testing and diagnosis

At Children’s Hospital of Philadelphia (CHOP), diagnosing a distal radius fracture typically begins with a physical examination of your child’s wrist, arm and hand.

In most cases, clinicians will recommend X-rays of your child’s wrist to confirm the diagnosis. X-rays produce images of bones and help doctors identify the type of fracture and extent of your child’s injury.

In addition to a physical exam and X-rays, your child may also undergo:

Treatment

• Accurate diagnosis helps us determine the best course of treatment for your child.
• Treatment for your child’s wrist fracture will depend on the type of fracture, as well as the age and development of your child.

Nonsurgical treatment

If your child’s distal radius fracture is not too severe and the bone is positioned correctly, the broken wrist will likely be placed in a plaster cast until the bone heals.

For children with a simple, displaced fracture — where the bone is not lined up properly — a procedure called a “closed reduction” may be needed to reposition the bone. In this procedure, the bone is straightened without having to open the skin. Clinicians will give your child a local anesthesia to numb the area, and move the wrist fragments into alignment.

Once complete, a splint or cast will be applied to keep the bone in place as it heals. Depending on the complexity of the fracture and how much the area swells after the bone is repositioned, a splint may be used for a few days to allow the swelling to recede before a cast is applied.

Surgical treatment

If your child’s wrist fracture is severe, the bone is broken in multiple places, involves the joint, or the bones cannot be correctly positioned outside the skin, surgery will be necessary.

A pediatric anesthesiologist will give your child anesthesia to keep them from feeling pain and sensation during surgery. A surgeon will make an incision to access the bones in the wrist and move them into better alignment.

To stabilize the fracture and keep the bones in the correct position as they heal, the surgeon may use a cast, metal pins, plate and screws, external fixator or a combination of techniques. Your child’s doctor will discuss the best way to immobilize your child’s wrist as it heals.

Surgical safety

Though surgery for wrist fractures is highly effective, we understand that any surgery can be a stressful experience for children and families. At CHOP, we offer a wealth of resources about how to prepare your child for surgery and what to expect during surgery.

Follow-up care

Follow-up care for wrist fractures will depend on the treatment needed. Children with simple distal radius fractures that require a cast will be able to resume regular activities more quickly than those who need surgery.

Children with complex fractures who need surgery will wear a cast or external fixator for six weeks. When the cast or fixator is removed, X-rays are taken to insure your child’s wrist is healing properly.

Once the fracture is stable, your child will be encouraged to begin motion exercises to limit stiffness and regain range of movement. Depending on the complexity of your child’s fracture, physical therapy may also be recommended.

Your child’s doctor will give you specific information about a recovery program for your child and how soon he can return to daily activities.

Outlook

Wrist fractures are common — but temporary — conditions. Your child may have stiffness in their wrist for up to a year after the injury, but once their wrist has fully healed, there are generally no complications. Long-term follow-up is not necessary and complete recovery is typical.