Trauma

Distal Radius Fracture

Distal radius (wrist) fracture treatment in Townsville - conservative management and volar locking plate fixation. Dr Jonathon de Hoog, Aspire Orthopaedics.

Performed at: Townsville Day Surgery Mater Hospital Pimlico

What is a distal radius fracture?

The distal radius is the end of the forearm bone, at the wrist. It’s the most commonly fractured bone in adults. Most distal radius fractures happen from a fall onto an outstretched hand - typical in elderly patients after a low-energy fall, and in younger patients after higher-energy trauma (sport, motor vehicle accidents, cycling).

The fracture pattern can range from a simple, undisplaced crack to a comminuted, intra-articular injury involving the joint surface.

Symptoms

  • Immediate pain, swelling, and deformity at the wrist
  • Inability to move the wrist
  • Sometimes a visible “dinner fork” deformity
  • Occasionally, numbness or tingling in the hand from associated median nerve irritation

Diagnosis

  • Plain X-rays - confirm the diagnosis and characterise the fracture pattern
  • CT scan - used for complex intra-articular fractures to plan fixation

Non-surgical treatment

Undisplaced or minimally displaced fractures, and some fractures that can be manipulated back into good position, are treated in a cast:

  • Closed reduction (realignment) if needed, usually under local anaesthetic or sedation in the emergency department
  • Cast immobilisation for 4-6 weeks
  • Regular X-rays to confirm position is maintained

Surgical treatment

Surgery is considered when:

  • The fracture is significantly displaced
  • The fracture is intra-articular with joint surface disruption
  • The fracture is unstable and cannot be held in a cast
  • The patient is younger or higher-demand and needs a reliable early return to function

The standard operation is open reduction and internal fixation with a volar locking plate: a plate and screws placed on the front (volar) surface of the distal radius, through an incision on the front of the wrist. This restores the anatomy and allows early movement.

  • Performed at Townsville Day Surgery or Mater Hospital Pimlico
  • Regional block with light sedation
  • Typically 45-60 minutes
  • Day surgery for most patients

Recovery

  • Week 1 - light splint; gentle finger movement encouraged from day one
  • Weeks 1-2 - transition out of the splint; hand therapy begins; stitches out around 10-14 days
  • Weeks 2-6 - active wrist movement, progressive strengthening; driving typically around 4-6 weeks
  • Weeks 6-12 - return to most activities; desk work within 1-2 weeks, manual work 8-12 weeks
  • Months 3-6 - final grip and wrist movement

Hand therapy is central to recovery and is available through NQ Hand Care Clinic at the same North Ward location.

Risks

  • Stiffness - particularly of the fingers and wrist, minimised by early therapy
  • Tendon irritation or rupture - from the plate or screws; occasionally requires hardware removal
  • Median nerve irritation (carpal tunnel) - can occur acutely or later
  • Malunion or loss of reduction - uncommon with locking plate fixation
  • Complex regional pain syndrome - recognised complication
  • Infection - rare

Recovery timeline

What to expect at each stage of your recovery.

  1. Acute assessment

    Urgently

    Plain X-rays confirm diagnosis. CT scan for complex intra-articular fractures. Reduction if needed in emergency department.

  2. Treatment

    Promptly

    Undisplaced fractures cast for 4-6 weeks. Surgical fixation (volar locking plate) for displaced, unstable, or intra-articular fractures.

  3. Hand therapy begins

    1-2 weeks post-surgery

    Active wrist movement starts early after surgical fixation. Stitches out around 10-14 days.

  4. Return to activities

    6-12 weeks

    Driving typically around 4-6 weeks. Desk work within 1-2 weeks. Manual work 8-12 weeks. Final grip and wrist movement at 3-6 months.

Common questions

Frequently asked questions about this procedure.

Do all wrist fractures need surgery?

No. Many wrist fractures, particularly undisplaced or minimally displaced fractures in older patients, heal well in a cast over 4-6 weeks. Surgery is considered when the fracture is significantly displaced, involves the joint surface, is unstable in a cast, or when the patient is younger and higher-demand with a need for reliable early return to function.

When can I drive after a wrist fracture?

After surgical fixation, driving is typically possible around 4-6 weeks, once wrist movement and strength allow safe vehicle control. After conservative management in a cast, driving is restricted for the duration of immobilisation. Both wrists are relevant - the left hand is needed for gear changes and steering. This will be discussed specifically at your follow-up.

What is a volar locking plate?

A volar locking plate is a metal plate and screw system placed on the front (palm side) of the distal radius, through an incision on the front of the wrist. The locking screws hold the bone fragments in their corrected position while they heal. This approach restores the fracture anatomy and allows early movement, making it the standard surgical treatment for most displaced distal radius fractures.

Do I need a GP referral for a wrist fracture?

Acute wrist fractures are referred through emergency departments or GP urgent pathways and are typically seen rapidly at NQ Hand Care Clinic. For ongoing wrist problems after a previously managed fracture, a GP referral to Aspire Orthopaedics is appropriate.

Speak with Dr de Hoog

A GP referral is required to see Dr de Hoog. Ask your GP to refer you to Aspire Orthopaedics, or contact the rooms directly for guidance.

Get a referral Email the clinic