Anatomical Significance
The distal radius forms a critical component of the wrist joint and has several important anatomical features:
- It articulates with the carpal bones to form the radiocarpal joint
- It has a wide articular surface designed to distribute load across the wrist 3
- The distal radius contains specialized microstructure that helps absorb and transmit forces:
- A 2mm multilaminar subchondral bone plate (thicker in areas of maximal load)
- Trabecular columns that transmit forces from the articular surface to the volar cortex
- Metaphyseal arches that distribute load proximally and laterally 3
Clinical Relevance
Understanding the distal radius is crucial because:
- Distal radius fractures are among the most common orthopedic injuries 1
- They account for approximately 25% of fractures in the pediatric population and 18% in the elderly 1
- These fractures show a bimodal distribution, occurring more frequently in younger (<18 years) and older (>65 years) populations 1
- The annual incidence exceeds 640,000 cases in the United States alone 1
Fracture Patterns and Management
Distal radius fractures range from simple isolated fractures to complex comminuted fractures with associated injuries. The fracture pattern typically depends on:
- Mechanism of injury
- Energy imparted
- Bone quality of the patient 1
Management options include:
- Conservative treatment with immobilization (for stable fractures with minimal displacement)
- Surgical intervention with open reduction and internal fixation (for unstable fractures)
- Early finger motion exercises to prevent stiffness regardless of treatment approach 2
Common Pitfalls in Clinical Practice
- Failing to recognize associated injuries to the distal radioulnar joint
- Overlooking the importance of restoring proper alignment (ulnar inclination, volar inclination, and radial length)
- Inadequate assessment of fracture stability
- Delayed mobilization leading to stiffness and poor functional outcomes 2
The distal radius has a unique microstructure resembling an arch bridge that allows it to absorb impact and transmit forces effectively, which is important to consider when treating injuries to this region 3.