A chauffeur fracture happens when the end of the radius bone (radial styloid process) in your forearm breaks. Chauffeur fractures occur from trauma because of falls, accidents or sports injuries. Providers can treat your broken bone with a cast, external fixation device or surgery. Gentle exercises and physical therapy can help restore wrist strength.
A chauffeur fracture is a broken bone near your wrist. There are two long bones in your forearm: the radius and the ulna. A chauffeur fracture occurs when the pointed tip at the end of your radius (radial styloid process) breaks.
A chauffeur fracture is a type of distal radius fracture, which means the break is at the end of the radius bone. A chauffeur fracture also extends into your wrist joint. When a fracture crosses into a joint, providers call it an intraarticular fracture.
Chauffeur fractures have many names, including radial styloid fractures, Hutchinson fractures and backfire fractures.
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Anyone can get a chauffeur fracture, but most people with distal radius fractures are either active younger people or people over age 65. Older people with osteoporosis are at higher risk.
Distal radius fractures are the most common fracture treated by U.S. healthcare providers. This type of fracture makes up nearly 17% of all fractures treated in emergency rooms. More than 450,000 people in the U.S. have distal radius fractures each year.
French orthopaedic surgeon Just Lucas-Championnière named this fracture after the many chauffeurs who started cars in the early 20th century. At the time, people started cars by vigorously turning a crank-handle clockwise. Sometimes the start of the motor caused the crank handle to jerk back. This led to a person’s hand twisting backward at the wrist and breaking the tip of the radial bone.
Trauma to your wrist causes a chauffeur fracture. This trauma may result from a:
If you have a chauffeur fracture, you may experience the following symptoms in your wrist:
Your healthcare provider will ask about symptoms and examine your wrist and other parts of your body for signs of trauma. They’ll also do a neurologic assessment to check for nerve function in your arm and hand. They may also do the following:
Providers aim to put the broken bones back into their original place and keep them there while they heal. Treatment for a chauffeur fracture depends on:
Treatments for chauffeur fractures can be nonsurgical, though many of these fractures require surgery to heal. Treatments include:
Closed reduction and casting: Your provider will move your bones back into place if needed. This happens without making an incision into your skin. They will place a splint over your fracture for several days and then replace it with a plaster cast. Your provider may change your cast after two to three weeks and check X-rays along the way to ensure your fracture hasn’t changed. They usually fully remove your cast after about six weeks.
External fixation: Your provider places an external fixation (stabilizer) device across your wrist joint, attached by metal pins. They may use this treatment if bones fail to stay in place with a cast or you have multiple areas of trauma.
Limited open reduction: Your provider uses a small incision to move your bones back into their original place. Then, they use an external fixation device to maintain the position. Your provider may use this technique when your bones have shifted more than 2 millimeters.
Open reduction and internal fixation (ORIF): Your surgeon makes an incision in the volar part of your wrist (the front part, or the area where you feel your pulse). They reattach the pieces of your bone and hold them in place with a plate and screws. Some surgeons are now using 3D printing to create models of the area to increase accuracy.
Complications of treatment vary from person to person. The most common complication is when a fracture heals in a less than optimal position (malunion). This can result in a bone that’s shorter, twisted or bent. Other complications may include:
Healing time after treatment varies from person to person. You may heal more slowly if you’re older or have other conditions such as osteoporosis or diabetes.
You can reduce your risk of developing a chauffeur fracture by:
If you have surgery for a chauffeur fracture, your surgeon will place a splint on your wrist for about two weeks. During your follow-up visit, they’ll give you a removable splint to wear for about four weeks.
A chauffeur fracture may cause pain for a few days to a few weeks. Your provider may recommend pain relief, such as ibuprofen and acetaminophen. They may prescribe a stronger medication for severe pain.
Your provider will also show you gentle exercises to keep your wrist and fingers moving. They may recommend physical therapy to build up strength and movement in your wrist.
You may have stiffness and pain in your wrist for up to two years. Physical therapy can help you regain motion in your wrist.
You can usually start light activities, such as swimming, about one to two months after cast removal or surgery. You can begin more energetic activities such as rugby or snowboarding about three to six months after cast removal or surgery.
Full recovery can take at least one year. Some people may experience permanent aching or stiffness, especially if:
See your provider if you’re not able to move your fingers within 24 hours after you get a cast or have surgery due to swelling or pain. You should try to regain the full motion of your fingers as soon as possible.
A note from Cleveland Clinic
A chauffeur fracture is a break in the radius bone near your wrist. Providers can successfully treat chauffeur fractures with a cast, an external fixation device or surgery. If you experience any complications after chauffeur fracture treatment, talk to your provider about whether medications or physical therapy may help. Most people are able to return to their regular activities within a few months after they recover.
Last reviewed by a Cleveland Clinic medical professional on 03/02/2022.
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