Stair Fall Wrist Fracture: Mechanism, Diagnosis & Treatment

Falling down stairs commonly causes distal radius fractures (Colles', Smith's) from FOOSH (fall on outstretched hand).

Mechanism

• Body weight + momentum → axial load on extended wrist.
• Dorsiflexion → Colles' (dorsal displacement).
• Volar flexion → Smith's (volar displacement).
• Scaphoid fracture also common (snuffbox tenderness).

Symptoms

• Immediate pain, swelling, deformity ("dinner fork" for Colles')
• Limited motion, tenderness.

Urgent Care

• Immobilize (splint), ice, elevate.
• X-ray (AP/lateral/oblique). CT if intra-articular/comminuted.
• Reduction (closed) if displaced → splint/cast.
• ORIF (plate/screws) for unstable, intra-articular, open fractures.

Recovery

• Cast 6 weeks → PT for ROM, strength.
• Full recovery 3–6 months.
• Complications: malunion, stiffness, post-traumatic arthritis, CRPS.

Osteoporosis screening (DEXA) if >50 or risk factors. Fall prevention: handrails, lighting, footwear.