Treatment of Non-Displaced Distal Radius Fracture in a 13-Year-Old Female
A removable splint for 3 weeks is the recommended treatment for this non-displaced distal radius fracture, with immediate active finger motion exercises to prevent stiffness. 1
Primary Treatment Approach
Use a removable splint rather than rigid casting for this minimally displaced fracture, as recommended by the American Academy of Orthopaedic Surgeons (AAOS). 1 This approach provides adequate immobilization while allowing early mobilization and preventing stiffness. 2
Duration of Immobilization
- Immobilize for 3 weeks rather than the traditional 4-6 weeks. 1, 3
- Research demonstrates that 3 weeks of immobilization leads to significantly better functional outcomes (lower PRWE and QuickDASH scores) compared to 5 weeks, with no increase in complications or secondary displacement. 3
- Even shorter periods (1 week) have been shown safe for non-displaced fractures, though 3 weeks represents a balanced, evidence-based approach. 4
Immediate Post-Diagnosis Management
Initiate active finger motion exercises immediately following splint application to prevent stiffness, which is one of the most functionally disabling complications of distal radius fractures. 1
- Finger motion does not adversely affect adequately stabilized distal radius fractures in terms of reduction or healing. 1
- Early wrist motion is not routinely necessary following stable fracture fixation. 1
Radiographic Follow-Up Protocol
- Obtain radiographs at 3 weeks post-injury to confirm adequate healing. 1, 2
- Repeat imaging at the time of immobilization removal to ensure proper consolidation. 1
- Consider obtaining radiographs between 1-2 weeks after initial treatment to detect early angulation, particularly important in pediatric patients. 5
Red Flags Requiring Surgical Consultation
Monitor for parameters that would indicate surgical fixation instead of conservative management:
- Radial shortening >3mm 1
- Dorsal tilt >10° 1
- Intra-articular displacement 1
- Any significant displacement that develops during follow-up 3
Adjunctive Measures
- Consider vitamin C supplementation for prevention of disproportionate pain (moderate recommendation strength from AAOS). 1
- Ice application may be used for symptomatic relief. 1
- Monitor for immobilization-related complications (skin irritation, muscle atrophy) which occur in approximately 14.7% of cases. 1
Pediatric-Specific Considerations
At 13 years old, this patient has approximately 2-3 years of remaining growth potential, which provides excellent remodeling capacity:
- In children less than 9 years old, up to 15 degrees of angulation is acceptable; for children 9 years or older, 10-15 degrees of angulation is acceptable depending on fracture location. 5
- Complete bayonet apposition is acceptable as long as angulation does not exceed 20 degrees and 2 years of growth remains. 5
- This patient's age and non-displaced fracture pattern make her an ideal candidate for conservative management with excellent expected outcomes. 5