The Broken Wrist
The Broken Wrist
A broken wrist is a break or a crack in one of the bones in the wrist. The most common cause of a fracture in the wrist is a fall on the outstretched hand or arm. These injuries often occur in the young from sporting activities or after a simple fall in the elderly due to osteoporosis. Osteoporosis is a disorder where the bone become fragile and weak, making it more prone to fractures. Many fractures in the wrist in the elderly arises after a fall from a standing position.
It is important to treat a broken wrist as soon as possible. If not, there is a risk that the bone will not heal in the proper alignment. This will affect the ability of the affected wrist or hand to perform everyday activities such as writing. Proper treatment early on will reduce the problems of pain, stiffness or weakness if neglected.
Symptoms of a broken wrist
If you’ve had an injury to your wrist and experience these symptoms, you might have broken your wrist.
- Severe pain in the wrist or hand
- Moving the wrist or fingers causes pain
- Swelling
- Tenderness in the wrist
- Bruising
- Obvious deformity in the wrist, e.g the “dinner fork” deformity
- Numbness in the hand
If the injury is not very painful or the wrist is not deformed, it may be possible to wait until the next day to see the doctor. An ice pack can be applied to help with the pain and swelling. Having the wrist and hand elevated on a soft pillow or cushion is useful.
Treatment
Treatment of broken bone follow these simple rules:
- To reduce the fracture (place the broken pieces back into its original position)
- Maintain the position of the fracture fragments until healing
There are many treatment options for a distal radius fracture. The choice depends on many factors such as the severity of the injury, the patient’s age and activity level and the overall health of the patient.
Non-Surgical Treatment
If the fracture or broken bones are in a good position, a plaster cast can be applied until the bone heals.
What is more common is that the position of the broken bones is out of place. In this situation, it is necessary to re-align the fragments back to the original position. Leaving it misaligned can cause problems like stiffness, pain and swelling in future. The process of manipulating the bones back to position is called “closed reduction”. Once the broken fragments are in a good position, the hand and wrist are placed in a plaster cast. This needs to be monitored until healing is completed. Closer monitoring may be needed if the fracture is thought to be less stable. In our hot and humid climate, it is important to keep the arm cool and dry. Never try to use long sticks and objects to scratch the hand inside the cast.
The cast is usually removed at 6 weeks after and physiotherapy is often started to help improve the motion and function of the wrist and hand. The fracture takes an average of 3 months to heal completely.
Surgical Treatment
Surgical treatment for distal radius fractures may be required if the fracture pattern is such that the bones cannot be corrected or kept corrected in a proper position using a cast. If not properly treated, there is possibility of inadequate healing or healing in a poor position that result in the function of the wrist and hand to be impaired in future.
During surgery, the fracture fragments are manipulated back into their original positions via an open incision on the wrist. This is called “open reduction”. Once achieved, the fracture is often fixed with a metal implant consisting of a plate and screws.
With open fractures, surgery is required on an urgent basis. The exposed soft tissue wound and the fractured bone must be thoroughly cleaned (debrided) and antibiotics are usually given to prevent infection. Should the soft tissues about the fracture be badly injured, an external fixator may be used to stabilise the fracture. Definitive fixation with plate and screws can be done several days after.
Recovery
There is a large variability in the severity and types of distal radius and wrist fractures. The treatment options and recovery process is therefore different with each individual. It is important to talk to the doctor and he will tell you the details regarding your injury and recovery path.
In general, most surgical wounds take 10 days – 2 weeks to heal. After surgery, the doctor will prescribe you a course of medicines to relieve pain. The fracture takes about 3 months to heal completely. Most patients will have some stiffness in the wrist due to the nature of the injury. The doctor will start you on physical therapy as soon as you are ready to maximise the recovery of the wrist. Light activities can be resumed at about 6 weeks after surgery while more strenuous activities can be started at 3- 4months.
Prevention
It is impossible to prevent the unforeseen events. However, these simple steps and tips can offer some protection.
We can build strong bones by:
- Having a healthy diet with adequate calcium and vitamin D.
- Participating in impact or load bearing exercises such as jogging will help increase the bone mass.
- Stopping smoking
We can minimise accidents and falls by:
- Wearing proper foot wear
- Remove home hazards, such as loose rugs. Many falls occur at home!
- Have adequate lighting and install night lights.
- Ensure your vision is checked and corrected.
- Consider installation of hand rails and grab bars in the toilets and stairways.
- Wearing protective gear at sports such as knee and wrist guards.
Why Choose Us?
Dr. Deepak Kumar and Dr. Neetu Gagneja are an experienced orthopaedic surgeon who specializes in
THE BROKEN WRIST
They will assess your condition and advise the best form of treatment for your condition. With proper treatment, patients can look forward to a full and quick recovery without complications.