Case 25 2026: Closed Reduction of a Distal Radius Fracture in the Emergency Department

Keywords: Distal radius fracture, closed reduction, fracture management, Colles’ fracture, orthopedic injury Authors: Maria Lerche Mortensen and Philip Månsson. Institution: Department of Orthopedic Surgery, SUH Nykøbing Falster, Denmark Abstract A 62-year-old female presented to the emergency department after a fall from standing position, attempting to break the fall with her left hand. She presented with pain, swelling, and a visible deformity of the wrist. A distal radius fracture of Colles’ type was diagnosed. She was treated in the emergency department in accordance with local guidelines, with closed reduction using both Chinese finger traps and manual reduction with a hematoma block for analgesia. Finally, a dorsal below-elbow cast was applied, and the patient was referred for follow-up after 10-12 days. Patient medical history This patient was active and employed, able to take care of herself, her family and household. She had no past fractures, no relevant medication, and no known allergies. Before and After Patient examination Patient history was obtained, involving circumstances of the trauma, including reasons to suspect underlying disease or other injuries. She fell while walking on a slippery surface, described the trauma as “just bad luck”, she reported no other complaints of pain, had intact memory, and had no cardiac symptoms prior to fall. The clinical examination included inspection, palpation, and function. Inspection: A bayonet deformity was observed, with significant swelling over the radial styloid. There were no wounds or discoloration. Palpation: There was a palpable step-off, and pain over the distal radius. Elbow, hand and fingers were palpated without pain. Therefore, there was no suspicion of other injuries. Function: Neurological and vascular integrity were intact. The motor function was tested: n. ulnaris – finger abduction with intact strength; n. radialis – extension of the MCP-joints; n. medianus – opposition of the first digit. The