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.

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Types of Hand & Wrist Fractures

Common Types of Wrist Injuries and Fractures

1. Colles’ Fracture: A distal radius fracture with dorsal displacement of fragments.
2. Smith’s Fracture: A distal radius fracture with volar displacement of fragments.
3. Scaphoid Fracture: A fracture of the scaphoid bone, often caused by falls on an outstretched hand.
4. Barton’s Fracture: A fracture-dislocation of the radiocarpal joint.
5. Chauffeur’s Fracture: A fracture of the radial styloid.
6. Greenstick Fractures: Fractures in children where the bone bends and cracks.
7. Ulnar Styloid Process Fracture: A fracture of the ulnar styloid process, often associated with distal radius fractures.

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Diagnosis

Imaging Tests

1. X-rays: The primary imaging technique to diagnose wrist fractures. They can reveal the type and severity of the fracture.
2. MRI: Used for detailed images of soft tissues, bones, and ligaments.
3. 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.

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Treatment

Non-surgical Options

1. Casting and Splinting: Immobilizes the fracture to allow healing. Typically used for non-displaced or minimally displaced fractures.
2. Bracing: For minor injuries or post-surgery support.
3. Pain Management: NSAIDs like ibuprofen or acetaminophen to reduce pain and inflammation.

Surgical Options

1. Open Reduction and Internal Fixation (ORIF): Involves making an incision to realign the bone fragments and securing them with plates and screws.
2. External Fixation: Using an external frame to stabilize the bones.
3. Percutaneous Pinning: Inserting pins through the skin to hold bones in place.

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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.

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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.

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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.