Radius bone – structure, functions, injuries. Rehabilitation after a radius fracture

Proven content

The radius is the thicker and shorter bone of the two long bones of the forearm. It is located on the side of the forearm, parallel to the ulna (in anatomical position with the arms hanging down the sides of the body, palms facing forward). The radius and elbow rotate around each other to allow the wrist to turn. Together with the humerus, they form the elbow joint. Of the two bones in the forearm, the radius is more prone to fracture than the ulna. In children, more than 50% of all forearm fractures are related to the radius only, 6% only of the ulna, and 44% of both. Radial bone fractures are also very common in adults.

Radius bone – structure

A radius is a long bone, one of the four types of bones in the body. Long bone is a dense, strong bone characterized by being longer than wide. The beginning of the long bone is called the shaft, and the end is called the base. The shaft is hollow and inside there is a space called the medullary cavity where the bone marrow resides.

The structure of the radial bone

The length of the radius is from 20 to 26,5 cm in adults. An average of 24 cm for men and 22 cm for women. The distal epiphysis of the radius (distal end at the wrist) is on average about 2,5 cm wide. The proximal base (the end at the elbow) is about half as wide. The radius bone is a typical long bone. At the ends of the radius, there is a spongy substance that hardens with age.

Location of the radius

The radius is in the forearm, the humerus between the elbow and the wrist. In the anatomical position with the arms straightened and the palms stretched forward at hip level, the radius is parallel and lateral to (outside) the ulna. In a resting position, such as with your hands on the keyboard, the distal (distal) ends of the radius and ulna intersect with the radius lying on the ulna.

The proximal end of the radius forms the lateral (outer) edge of the elbow joint at the distal end of the humerus. The distal end of the radius bone attaches to the wrist just in front of the thumb.

The rotation of the radius and ulna allows rotation of the wrist at the distal radioulnar joint. The radius provides stability to the hinge joint at the elbow and allows movement in the radiopaque joint, but the elbow and the humerus do most of the work there. There is some movement between the proximal end of the radius and the ulna, called the proximal radioulnar joint.

The radius and ulna are connected by a layer of thick fibrous tissue called the interosseous ligament or interosseous membrane. A smaller ligament connects the proximal ends of the radius and ulna. We are then talking about the so-called oblique string whose fibers run in the opposite direction to the interosseous membrane.

Anatomical variations of the radial bone

In some cases, the radius may be short or underdeveloped. One variation seen in radius anatomy is proximal radioulnar synostosis, in which the radius and ulna are fused, usually closer to one third (closest to the elbow), but can rarely occur after bone trauma such as dislocation.

See also: Human skeletal system

Radius bone – functions

The radius allows the arm to move and, in particular, provides full range of motion for the hand and wrist. The radius and ulna work together to provide adequate leverage to lift and rotate objects. When crawling, the radius can also help provide mobility. The radius bone also plays a large role when lifting weight, such as push-ups.

There are seven muscle attachment points in the radial bone:

1. the invertor muscle (Latin musculus supinator);
2. biceps brachii (Latin musculus biceps brachii);
3. superficial flexor muscle of the fingers (Latin musculus flexor digitorum superficialis);
4. inverted round muscle (Latin musculus pronator teres);
5. long flexor muscle of the thumb (Latin musculus flexor pollicis longus);
6. the brachio-radial muscle (Latin musculus brachioradialis);
7. recurrent trapezius muscle (Latin musculus pronator quadratus).

Radius bone – injuries

The most common disease condition of the radius is its fracture. The radius, although shorter and slightly thicker than the ulna, is more likely to break. It would seem that it is the longer ulna that more force will be exerted during falls or other mechanisms of injury. However, the radius is one of the most frequently broken bones in all age groups. The distribution of weight when falling to the ground, when the patient relieves the fall by lowering the arms, exerts the greatest pressure on the radius. Interestingly, it is possible to fracture only the radius, only the ulna, or both of the forearms.

Fractures of the distal end of a radius are the most common type of radius fracture. Elderly patients and pediatric patients are more likely to experience these types of fractures than young adult patients when falling onto their arms outstretched. Elderly patients are at risk of fracture of the radial head, which refers to the proximal end of the radius that forms part of the elbow.

Pediatric patients are more likely to develop incomplete fractures, often referred to as “green branch” fractures (subperiosteal fractures), due to the flexible nature of immature bone tissue. Pre-pubertal patients are also at risk of damage to the epiphyseal plate (growth plate). It is important to be aware that damage to the growth plate can lead to long-term deformation.

Regardless of the type and severity of the radius fracture, symptoms typical of all long bone fractures should be expected. Pain is the most common symptom of any fracture and is the only symptom that can be considered universal. Pain after a fall on an outstretched arm can lead to pain in the wrist, forearm, or elbow. All of this may indicate a rupture of the radial bone.

Any other sign or symptom of a fracture may or may not be present. Other signs and symptoms of a fracture include deformity, tenderness, crackling (a grinding feeling or sound from the ends of broken bones rubbing together), swelling, bruising, and loss of function or sensation.

Radial fractures are not life threatening and do not require emergency medical intervention or even an emergency room visit. Often times, a visit to the doctor can start the process of diagnosing and treating a radius fracture, as long as your doctor is able to arrange an x-ray.

See also: Bow. Łukasz Durajski: The hospital is cluttered with pediatric COVID-19 patients

Radius bone – rehabilitation after a fracture

Treatment and rehabilitation of the radial bone after a fracture depends on the severity and location of the injury. Treatment begins with immobilization of the fracture site. The ends of the bones must be placed back in the correct anatomical position (known as bone alignment) to support proper healing. Be aware that if the bone is not placed in the correct position, new bone growth can cause permanent deformation.

The type of fixation used depends on the type and location of the fracture. Severe fractures may require surgical immobilization, while minor fractures may be immobilized by manipulation and plaster or splint placement. In many cases, slings may also be necessary to strengthen immobilization as the patient carries out daily activities for the weeks needed to heal the fracture.

After immobilization, long-term rehabilitation includes physical therapy. The physical therapist will be able to teach the patient to stretch and strengthen exercises that apply adequate pressure to the appropriate areas after the fracture. Physiotherapy will improve the strength and range of motion of the elbow and wrist. Physiotherapy may also be necessary for the shoulder due to the immobilization of the injured shoulder. Not being able to use the forearm means the patient probably isn’t moving the arm too much.

Surgical repair or the repair of severe fractures may require more than one operation to fully repair the injury. Moreover, each operation requires a healing period, and the patient may need the help of a physical therapist to restore all preoperative functions in the injured arm. It is worth adding that in the case of certain injuries, several months may elapse between surgical procedures, which requires rehabilitation after each procedure.

Rehabilitation of a radius fracture may take two to three months for the damaged area to return to its pre-injury state. It’s important to follow your physical therapist’s recommendations and keep abreast of all exercise and treatments. Long delays between treatment sessions or the lack of exercise outside the physiotherapy office can inhibit the healing process and even lead to repeated injuries.

See also: Rehabilitation after a radius fracture

Radial fracture and osteoporosis

A fracture of the distal radius (also called a Colles fracture) or a wrist fracture, which often happens when someone reaches out to save themselves in a fall, is often the first sign of osteoporosis. In fact, most of these injuries are at least partly due to bone loss. With this in mind, doctors who specialize in hand and wrist fractures are particularly knowledgeable about overall bone health.

Osteoporosis is a disease in which bones become brittle and likely to break. This is often the case throughout life as a result of insufficient intake of calcium and vitamin D. Our bodies store calcium in our bones but use it in many other systems.

Typically, a person who gets enough calcium and vitamin D will be able to supply other systems with the calcium they need to function properly. However, if a person is not getting enough calcium and vitamin D, their body will begin to break down the calcium stored in their bones to compensate for this. If this happens over a long period of time, it can lead to osteoporosis.

Radius bone – prophylaxis

Bone health is important to your overall well-being. Bone loss and osteoporosis don’t hurt, so you may not realize you are affected by this issue until you break a bone, such as your wrist. To keep your bones healthy, doctors who specialize in distal radius fractures recommend the following guidelines.

1. Avoid alcohol and tobacco – overuse of these substances can contribute to bone loss. Try to avoid tobacco completely and drink no more than two alcoholic drinks a day;
2. Exercise regularly – exercise helps to strengthen bones and contributes to overall health;
3. Use a balanced diet – make sure that we provide the body with the recommended daily dose of calcium and vitamin D.

Let’s talk to your doctor about whether we need calcium or vitamin D supplementation.

If we are concerned that our diet is not providing enough nutrients, or if we have multiple risk factors for osteoporosis and are concerned about bone loss, let’s talk to your doctor about whether adding supplements to our daily diet would be beneficial for us.