What is the initial management for a closed, angulated distal radius fracture after FOOSH?

• A. Immobilize with a splint or cast and obtain orthopedic evaluation.
• B. Immediate surgical fixation
• C. Physical therapy
• D. Observation

Answer: (A)

Initial management focuses on stabilization and preventing further injury. For a closed, angulated distal radius fracture after a fall on an outstretched hand, immobilize the wrist with a splint or cast to protect the fracture and control pain, while elevating the arm to reduce swelling. Perform a quick neurovascular check to ensure blood flow and sensation are intact.

Arrange orthopedic evaluation promptly to decide if closed reduction is needed and to plan definitive care. Immediate surgical fixation isn’t required unless there are emergency factors such as an open fracture, neurovascular compromise, or an unstable fracture that cannot be maintained with immobilization. Physical therapy and observation alone aren’t appropriate as the initial step because proper alignment and healing need immobilization and specialist assessment first.