Wrist Fracture FAQs with an Orthopaedic Surgeon

More than ever in this technologically advanced age, we rely on the hands and wrist to interact with computers and other devices on a daily basis. For many, their work depends on the use of their wrists. Laborers and office workers alike stress that their wrists are crucial to the work that they do. Thus, when a wrist injury occurs, it is imperative to get the right information and the help you need immediately. Preparation is invaluable—get the information now you need for wrist fracture procedure treatments.

What constitutes a wrist fracture?
A wrist fracture is a break in the distal radius, which is the end of the radius arm bone closest to the hand. As the most common break in the arm, there are many different variations depending on the location and severity of the fracture, such as the:

• Colles fracture
• Intra-articular fracture
• Open fracture
• Comminuted fracture
• Extra-articular fracture

The fracture can be classified as displaced or nondisplaced which refers to the angle of the bone break. A displaced fracture is when broken pieces of the bone do not line up straight according to the natural bone placement. When the break encompasses more than the wrist and the forearm ulna bone is also fractured, it is classified as a distal ulna fracture.

Who is qualified to help?
The provider most qualified to help is an orthopaedic specialist. Because treatment options can range from conservative to surgical, in some instances an individual will be seeking a consultation with an orthopaedic surgeon. If you first visited your family physician, you will receive a referral to an orthopaedic provider. In the greater Philadelphia area, Rothman Orthopaedic Institute hand and wrist surgeons take a team approach to treatment and combined have more than 50 years of collective clinical experience in their specialty.

Which treatment option is right for me?
The right treatment option will be recommended to you by your doctor after your symptoms are evaluated and the diagnosis has been completed. Wrist fracture symptoms that will be evident include pain, tenderness, bruising, and swelling. Some experience deformity, or a limp hanging, of the wrist at the point of the break. X-rays will show the number of broken bones, where they reside, and whether or not other bones like the ulna are broken.

A wrist that does not hang may be protected with a splint and an ice pack. It should be elevated and a doctor’s visit can wait until the following day. More urgency is required if there is excessive pain, any type of wrist deformity, a numbing sensation anywhere in the arm or hand, or the fingers are discolored and abnormal. In that case, a trip to the emergency room is necessary.

Nonsurgical treatment: An aligned (natural bone position) break will require a plaster cast until the bone heals. If the broken pieces are not aligned and are out of place, the doctor will cut the skin to realign them in a procedure called a reduction. If the skin does not need to be cut for alignment, it is a closed reduction wrist fracture procedure. The wrist will be swollen to the point where a plaster cast will be applied. The cast is changed by the doctor every two to three weeks and in some cases x-rays may be taken periodically by your doctor to track the condition of the wrist fracture. Physical therapy will restore strength to the wrist after the plaster cast is removed.

Surgical treatment: Surgery is when a cast cannot contain the break or when the wrist fracture is severe to the point where the normal function of the arm could be compromised if the wrist does not heal correctly and accurately. During an open reduction surgery, metal pins, plates, screws, or an external fixator will be installed to improve alignment. Open fracture surgery is required when the skin, soft tissue, and bone were exposed during a wrist fracture that broke through the skin. In this procedure, the tissue and bone must be cleaned and antibiotics applied to prevent infection.

Patients’ experiences with wrist fracture treatments are very broad and varied. Recovery and healing time is different for each individual depending on the circumstances of the fracture. Hand and wrist specialists at Rothman Orthopaedic Institute are confident that with the right wrist fracture procedure, a return to activity is inevitable.

For more information, contact us for an appointment at 1-800-321-9999.