Pucker sign in an adult distal radial fracture.

Puckering of the skin following a fracture is a rare sign which can result in skin necrosis if the fracture is not urgently reduced. Skin puckering is associated with humeral, tibia and clavicular fractures. We present a case of a 79-year-old woman who fell on to her outstretched hand sustaining a right radial fracture with obvious skin puckering. Following X-rays, local anaesthetic was given and the skin was reduced, the fracture manipulated and a full cast applied. The patient made a full recovery. To our knowledge, this is the first reported case of the pucker sign in an adult radial fracture.