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Wrist Injuries & Fractures
Wrist injuries and fractures are common, especially due to falls or high-impact activities. Understanding the types, diagnosis, and treatment options is crucial for effective management and recovery.
Types of Hand & Wrist Fractures
Common Types of Wrist Injuries and Fractures
- Colles’ Fracture: A distal radius fracture with dorsal displacement of fragments.
- Smith’s Fracture: A distal radius fracture with volar displacement of fragments.
- Scaphoid Fracture: A fracture of the scaphoid bone, often caused by falls on an outstretched hand.
- Barton’s Fracture: A fracture-dislocation of the radiocarpal joint.
- Chauffeur’s Fracture: A fracture of the radial styloid.
- Greenstick Fractures: Fractures in children where the bone bends and cracks.
- Ulnar Styloid Process Fracture: A fracture of the ulnar styloid process, often associated with distal radius fractures.
Diagnosis
Imaging Tests
- X-rays: The primary imaging technique to diagnose wrist fractures. They can reveal the type and severity of the fracture.
- MRI: Used for detailed images of soft tissues, bones, and ligaments.
- CT Scan: Provides 3D images for complex fractures and surgical planning.
Physical Examination
Your doctor will assess:
- Pain and tenderness: Location and severity.
- Swelling and deformity: Visible changes in the wrist structure.
- Range of motion: Ability to move the wrist and fingers.
- Nerve function: Checking for numbness or tingling.
Treatment
Non-surgical Options
- Casting and Splinting: Immobilizes the fracture to allow healing. Typically used for non-displaced or minimally displaced fractures.
- Bracing: For minor injuries or post-surgery support.
- Pain Management: NSAIDs like ibuprofen or acetaminophen to reduce pain and inflammation.
Surgical Options
- Open Reduction and Internal Fixation (ORIF): Involves making an incision to realign the bone fragments and securing them with plates and screws.
- External Fixation: Using an external frame to stabilize the bones.
- Percutaneous Pinning: Inserting pins through the skin to hold bones in place.
Recovery
Initial Phase
- Immobilization: Using a cast or splint to keep the wrist in place.
- Pain Management: Medication and elevation to reduce swelling and discomfort.
Rehabilitation
- Physical Therapy: To regain strength and range of motion. Exercises include wrist flexion, extension, and rotation.
- Gradual Return to Activities: Avoiding strenuous activities until fully healed.
Long-term Care
- Follow-up Appointments: Regular check-ups to monitor healing.
- Ongoing Exercises: To maintain wrist function and prevent stiffness.
Common Wrist Fractures
Colles’ Fracture
Occurs from a fall on an outstretched hand, resulting in a backward displacement of the wrist. Treatment typically involves reduction and casting, with surgery required for severe cases.
Smith’s Fracture
A reverse Colles’ fracture caused by falling onto a flexed wrist. It may require closed reduction and casting or surgery for severe displacements.
Scaphoid Fracture
Common in young adults from a fall on an outstretched hand. Treatment involves casting for non-displaced fractures or surgical fixation for displaced fractures to prevent non-union and avascular necrosis.
Complications
- Non-union: The bone fails to heal properly.
- Avascular Necrosis: Bone tissue death due to disrupted blood supply.
- Arthritis: Long-term joint damage from intra-articular fractures.
- Nerve Damage: Resulting in numbness or weakness.
- Stiffness and Pain: Persistent discomfort and limited motion.
Prevention
- Safety Gear: Wearing wrist guards during high-risk activities.
- Bone Health: Ensuring adequate calcium and vitamin D intake, and engaging in weight-bearing exercises.
- Fall Prevention: Using supportive footwear and removing tripping hazards at home.