Distal radius fracture natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

If left untreated, majority of patients with distal radius fracture may progress to develop malunion and loss of range of motion of the wrist and forearm. Common complications of distal radius fracture include upper extremity stiffness, malunion, carpal tunnel syndrome or median nerve involvement, and radiocarpal arthritis. Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.

• If left untreated, majority of patients with distal radius fracture may progress to develop malunion and loss of range of motion of the wrist and forearm.^[1][2]

• Common complications of distal radius fracture include:^{[3][4][5][6][7][8]}
  • Upper extremity stiffness
  • Carpal tunnel syndrome or median nerve involvement
  • Malunion
  • Injury to the radial artery
  • Carpal instability
  • Distal Radio-Ulnar Joint (DRUJ) dysfunction
  • Dupuytren’s disease
  • Radiocarpal arthritis
  • Tendon injuries
  • Ligament injuries
  • Post-traumatic osteoarthritis
  • Compartment syndrome
  • Infection mostly by open fractures or after fracture fixation
  • Complex regional pain syndrome

• Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.^[9][10]
• Most patients will likely lose a few degrees of final flexion and extension, and possibly supination as well; however, these limitations generally do not prevent full function.
• Some patients are unable to resume their prior level of functioning.
• All treatment approaches have a percentage of poor results, with decreased supination, prominent ulnar heads, ligamentous problems, distal radioulnar instability, and degenerative joint disease.

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