Snapshot A 72-year-old woman trips and falls on her outstretched right hand. She experiences immediate pain and swelling over her right wrist. On exam, she has a dinner-fork deformity of the wrist and exquisite pain with passive motion. A radiograph is shown, which reveals a dorsally angulated distal radius fracture. Introduction Clinical definition forearm fracture of the distal end of the radius login to view 3 more bullets Epidemiology Incidence most common forearm fracture Demographics bimodal distribution login to view 8 more bullets Risk factors osteoporosis other fragility fractures (vertebral compression fractures and femoral neck fractures) are predictive of subsequent fractures Etiology Fall on outstretched hand Pathoanatomy normal anatomy login to view 6 more bullets fracture location login to view 4 more bullets Associated conditions distal radioulnar joint (DRUJ) injury radial styloid fracture ligamentous injuries login to view 2 more bullets Presentation Symptoms severe wrist pain login to view 1 more bullet Physical exam swelling ecchymosis tenderness to palpation limited range of motion deformity corresponding to fracture angulation and displacement compartment syndrome should be carefully ruled out in forearm fractures Imaging Radiography indications login to view 1 more bullet findings login to view 8 more bullets Computerized tomography (CT) scan indications login to view 2 more bullets findings login to view 1 more bullet Magnetic resonance imaging (MRI) scan indication login to view 1 more bullet findings login to view 2 more bullets Differential Scaphoid fracture tenderness will be localized to the thenar snuffbox more than the distal radius radiographs will be normal or show a fracture line in the scaphoid DRUJ dislocation radiographs will demonstrate radioulnar instability Treatment Nonoperative closed reduction followed by immobilization login to view 2 more bullets Operative open reduction and internal fixation login to view 5 more bullets Complications Median nerve neuropathy acute carpal tunnel syndrome Extensor pollicis longus rupture Malunion or nonunion Prognosis Favorable well-aligned anatomic reduction Negative associated neurovascular injuries fracture shortening on pre-reduction radiographs osteoporotic bone old age