WRIST FRACTURES

Trauma Conditions Fractures Wrist Fractures

What are wrist fractures?

Wrist fractures are the most common injury sustained when a person falls on an outstretched hand. In the younger population, wrist fractures may go through the growth plate of the radius. In the older (more osteoporotic) population, the fracture tends to go through the softer metaphyseal part of the wrist bones with some compression on the dorsal (back) side of the wrist with some angulation, shortening and displacement, often displaying a dinner fork-type deformity. 


Wrist injuries are more than just a crack or break in the bone: they tend to involve the ulna (thinner bone) with the injury usually causing disruption of the joint between radius and ulna. There are associated soft tissue injuries that cannot be appreciated on normal X-rays. The TFCC (triangular fibrocartilage complex) is a meniscus-type structure in the wrist that stabilises the radius and ulnar and can be involved in up to 70% of wrist fractures. There might be associated carpal (scaphoid) bone fractures with other ligament injuries in up to 20% of wrist fractures. 

What are the signs and symptoms of a fractured wrist?

The wrist is a highly complex joint that involves the synchrony of ten bones and multiple soft tissue structures. The greatest problem with wrist fractures is stiffness and the loss of rotation, especially supination (turning the palm to the sky). Signs and symptoms of a fractured wrist include pain, swelling and difficulty in moving the hand and wrist. Swelling, or when the bone is out of place, may make your wrist appear deformed. This can be treated with early immobilisation. Left untreated, the broken wrist bone might not heal in proper alignment, which may affect your ability to do daily activities such as writing or buttoning your shirt. 

How are wrist fractures treated?

Most wrist fractures can be treated with a cast or splint to immobilise the wrist and thereby facilitate bone healing. In displaced or unstable wrist fractures, the best treatment is wrist surgery to reduce the bone fragments in the correct position and then stabilise the fracture by fitting a plate, which keeps the bone fragments in a reduced position. This is called an open reduction and internal fixation (ORIF). A stable fixation facilitates early mobilisation and ensures a good outcome.

Treatment goals for wrist fractures are to initially reduce swelling and promote movement of the fingers as soon as possible. In conservative management, Dr van der Spuy will immobilise your wrist for approximately 4-6 weeks in a cast. With a surgical fracture fixation, the period of immobilisation is usually shorter, between 2-4 weeks, and movement of the wrist can start once the fracture is stable enough. Most patients will experience stiffness and some discomfort and pain for up to six months post-surgery, depending on the severity and complexity of the wrist fracture.

FAQ

1Can a fractured wrist heal without the use of a cast?
There is still a possibility specific bones may heal without the need for a cast if they have a viable blood supply.
2Is a broken wrist a major injury?
A broken wrist is a painful injury. It can take six months or more to recover from the injury, depending on the extent of the fracture.
3Will it take long to recover from a fractured wrist?
It can take several months to a year to regain wrist function.

Please read the above text for more in-depth information to help answer these questions. It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.

Rehabilitation, including splinting, will be required to ensure good finger and thumb movement, as well as oedema and scar management in the early day’s post-injury/ hand surgery. Once the fracture is considered stable, hand therapy will help to regain movement of the wrist in all planes, build strength in the hand and facilitate the return to normal function. 

Wrist fracture pre-op

Wrist fracture after surgery