RT Journal Article SR Electronic T1 Pucker sign in an adult distal radial fracture JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e228046 DO 10.1136/bcr-2018-228046 VO 12 IS 4 A1 Mazin Al-salihy A1 Carlo Ross YR 2019 UL http://casereports.bmj.com/content/12/4/e228046.abstract AB 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.