Distal Radius Fractures: Operative vs. Non-Operative Treatment Options

What is a Distal Radius Fracture?

The distal radius is the end of the radius bone near the wrist. When this bone breaks—whether from a fall, sports injury, or car accident—it is called a distal radius fracture. It may be:

  • Displaced: the bone fragments are misaligned.
  • Non-displaced: the bone remains in its normal position.
  • Comminuted: the bone is broken into multiple pieces.
  • Intra-articular: the fracture extends into the wrist joint.

Common Causes of Distal Radius Fractures

  • Falling onto an outstretched hand (FOOSH)
  • Sports injuries (e.g., skiing, snowboarding, cycling)
  • Motor vehicle accidents
  • Osteoporosis-related fragility fractures

Symptoms of a Distal Radius Fracture

  • Immediate pain and swelling in the wrist
  • Deformity or a visible bump
  • Limited range of motion
  • Bruising or tenderness
  • Difficulty gripping or lifting objects

Diagnosis

A healthcare provider will typically order X-rays or CT scans to confirm the type and severity of the fracture.

Non-Operative Treatment Options

Non-operative (or conservative) treatment is generally recommended for:

  • Non-displaced or minimally displaced fractures
  • Stable fractures
  • Older patients with low functional demands
  • Patients who may not tolerate surgery well

1. Closed Reduction and Casting

  • Closed reduction involves manually aligning the bone without surgery.
  • The wrist is then immobilized in a cast or splint for 4–6 weeks.

2. Splinting Alone

  • Often used for stable fractures or initial swelling.
  • A splint allows for some movement while maintaining alignment.

3. Physical Therapy

  • After cast removal, rehabilitation exercises restore strength and range of motion.

Pros of Non-Operative Treatment:

  • No surgical risks (e.g., infection, anesthesia)
  • Lower cost
  • Shorter hospital stay

Cons:

  • Risk of poor alignment or malunion
  • Longer immobilization
  • Potential for stiffness and reduced function

Operative Treatment Options

Surgery is typically indicated when:

  • The fracture is displaced or unstable
  • There’s joint involvement (intra-articular fracture)
  • There is neurovascular compromise
  • Non-operative treatment has failed

1. Open Reduction and Internal Fixation (ORIF)

  • The most common surgical method.
  • Involves using a metal plate and screws to hold the bone fragments together.

2. External Fixation

  • A frame outside the body stabilizes the fracture using pins inserted into the bone.
  • Often used for severe or open fractures.

3. Percutaneous Pinning

  • Less invasive than ORIF.
  • Pins are placed through the skin to hold the bone in position.

Pros of Operative Treatment:

  • More accurate realignment
  • Early return to function
  • Lower risk of long-term deformity

Cons:

  • Surgical risks (infection, nerve injury, hardware irritation)
  • Higher cost
  • Longer initial recovery

Recovery Timeline

Treatment TypeImmobilizationReturn to ActivityPhysical TherapyNon-Operative4–6 weeks6–12 weeksAfter cast removalOperative (ORIF)1–2 weeks splint6–8 weeksEarly motion begins sooner

Which Treatment is Right for You?

Choosing between operative and non-operative treatment depends on:

  • Fracture type and stability
  • Your age and activity level
  • Overall health
  • Surgeon’s recommendation

A personalized treatment plan from an orthopedic specialist ensures the best outcome for your individual needs.

FAQs

Is surgery always necessary for a distal radius fracture?

No. Many fractures can be treated without surgery if they are stable and well-aligned.

How long does it take to heal?

Bone healing usually takes 6–8 weeks, but full recovery (including regaining strength and motion) can take 3–6 months.

Will I need physical therapy?

Yes, especially after cast removal or surgery, to restore wrist motion and function.

Final Thoughts

Distal radius fractures are highly treatable, and both non-operative and surgical options offer excellent outcomes when chosen appropriately. Early diagnosis and proper management are crucial to preventing long-term complications like stiffness, chronic pain, or deformity.

If you or a loved one has suffered a wrist fracture, consult an orthopedic hand or trauma specialist to explore your best treatment options.

Distal Radius Fractures: Operative vs. Non-Operative Treatment Options

Distal radius fractures are among the most common orthopedic injuries, especially in older adults and athletes. If you’ve recently been diagnosed with a wrist fracture, you might be wondering: Do I need surgery? or Can it heal without an operation? This blog explores both operative and non-operative treatment options for distal radius fractures to help you understand your choices and improve your recovery outcome.

By
Dr. Sameh Elguizaoui, M.D.
,
on
June 25, 2025

What is a Distal Radius Fracture?

The distal radius is the end of the radius bone near the wrist. When this bone breaks—whether from a fall, sports injury, or car accident—it is called a distal radius fracture. It may be:

  • Displaced: the bone fragments are misaligned.
  • Non-displaced: the bone remains in its normal position.
  • Comminuted: the bone is broken into multiple pieces.
  • Intra-articular: the fracture extends into the wrist joint.

Common Causes of Distal Radius Fractures

  • Falling onto an outstretched hand (FOOSH)
  • Sports injuries (e.g., skiing, snowboarding, cycling)
  • Motor vehicle accidents
  • Osteoporosis-related fragility fractures

Symptoms of a Distal Radius Fracture

  • Immediate pain and swelling in the wrist
  • Deformity or a visible bump
  • Limited range of motion
  • Bruising or tenderness
  • Difficulty gripping or lifting objects

Diagnosis

A healthcare provider will typically order X-rays or CT scans to confirm the type and severity of the fracture.

Non-Operative Treatment Options

Non-operative (or conservative) treatment is generally recommended for:

  • Non-displaced or minimally displaced fractures
  • Stable fractures
  • Older patients with low functional demands
  • Patients who may not tolerate surgery well

1. Closed Reduction and Casting

  • Closed reduction involves manually aligning the bone without surgery.
  • The wrist is then immobilized in a cast or splint for 4–6 weeks.

2. Splinting Alone

  • Often used for stable fractures or initial swelling.
  • A splint allows for some movement while maintaining alignment.

3. Physical Therapy

  • After cast removal, rehabilitation exercises restore strength and range of motion.

Pros of Non-Operative Treatment:

  • No surgical risks (e.g., infection, anesthesia)
  • Lower cost
  • Shorter hospital stay

Cons:

  • Risk of poor alignment or malunion
  • Longer immobilization
  • Potential for stiffness and reduced function

Operative Treatment Options

Surgery is typically indicated when:

  • The fracture is displaced or unstable
  • There’s joint involvement (intra-articular fracture)
  • There is neurovascular compromise
  • Non-operative treatment has failed

1. Open Reduction and Internal Fixation (ORIF)

  • The most common surgical method.
  • Involves using a metal plate and screws to hold the bone fragments together.

2. External Fixation

  • A frame outside the body stabilizes the fracture using pins inserted into the bone.
  • Often used for severe or open fractures.

3. Percutaneous Pinning

  • Less invasive than ORIF.
  • Pins are placed through the skin to hold the bone in position.

Pros of Operative Treatment:

  • More accurate realignment
  • Early return to function
  • Lower risk of long-term deformity

Cons:

  • Surgical risks (infection, nerve injury, hardware irritation)
  • Higher cost
  • Longer initial recovery

Recovery Timeline

Treatment TypeImmobilizationReturn to ActivityPhysical TherapyNon-Operative4–6 weeks6–12 weeksAfter cast removalOperative (ORIF)1–2 weeks splint6–8 weeksEarly motion begins sooner

Which Treatment is Right for You?

Choosing between operative and non-operative treatment depends on:

  • Fracture type and stability
  • Your age and activity level
  • Overall health
  • Surgeon’s recommendation

A personalized treatment plan from an orthopedic specialist ensures the best outcome for your individual needs.

FAQs

Is surgery always necessary for a distal radius fracture?

No. Many fractures can be treated without surgery if they are stable and well-aligned.

How long does it take to heal?

Bone healing usually takes 6–8 weeks, but full recovery (including regaining strength and motion) can take 3–6 months.

Will I need physical therapy?

Yes, especially after cast removal or surgery, to restore wrist motion and function.

Final Thoughts

Distal radius fractures are highly treatable, and both non-operative and surgical options offer excellent outcomes when chosen appropriately. Early diagnosis and proper management are crucial to preventing long-term complications like stiffness, chronic pain, or deformity.

If you or a loved one has suffered a wrist fracture, consult an orthopedic hand or trauma specialist to explore your best treatment options.