Hand/Wrist Fractures

Wrist Fracture

The wrist is comprised of two bones in the forearm, the radius and ulna, and eight tiny carpal bones in the palm. The bones meet to form multiple large and small joints. A wrist fracture refers to a break in one or more of these bones.

Types of Wrist Fracture

• Simple wrist fractures in which the fractured pieces of bone are well aligned and stable.
• Unstable fractures are those in which fragments of the broken bone are misaligned and displaced.
• Open (compound) wrist fractures are severe fractures in which the broken bones cut through the skin. This type of fracture is more prone to infection and requires immediate medical attention.

Causes of Wrist Fracture

Wrist fractures may be caused due to a fall on an outstretched arm, vehicular accidents or workplace injuries. Certain sports such as football, snowboarding, or soccer may also be a cause of wrist fractures. Wrist fractures are more common in people with osteoporosis, a condition marked by brittleness of the bones.

Signs and Symptoms of Wrist Fractures

Common symptoms of a wrist fracture include severe pain, swelling, and limited movement of the hand and wrist. Other symptoms include:

• Deformed or crooked wrist
• Bruising
• Numbness
• Stiffness

Diagnosis of Wrist Fractures

Your doctor performs a preliminary physical examination followed by imaging tests such as an X-ray of the wrist to diagnose a fracture and check alignment of the bones. Sometimes a CT scan may be ordered to gather more details of the fracture, such as soft tissue, nerves or blood vessel injury. MRI may be performed to identify tiny fractures and ligament injuries.

Your doctor will order a bone scan to identify stress fractures due to repeated trauma. The radioactive substance injected into the blood gets collected in areas where the bone is healing and is detected with a scanner.

Treatment of Wrist Fractures

Your doctor may prescribe analgesics and anti-inflammatory medications to relieve pain and inflammation.

Fractures that are not displaced are treated with either a splint or a cast to hold the wrist in place.

If the wrist bones are displaced, your surgeon may perform fracture reduction to align the bones. This is performed under local anesthesia. A splint or a cast is then placed to support the wrist and allow healing.

Surgery for of Wrist Fractures

Surgery is recommended to treat severely displaced wrist fractures and is carried out under the effect of general anesthesia.

External fixation, such as pins may be used to treat the fracture from the outside. These pins are fixed above and below the fracture site and are held in place by an external frame outside the wrist.

Internal fixation may be recommended to maintain the bones in proper position while they heal. Devices such as rods, plates and screws may be implanted at the fracture site.

Crushed or missing bone may be treated by using bone grafts taken from another part of your body, bone bank or using a bone graft substitute.

During the healing period, you may be asked to perform some motion exercises to keep your wrist flexible. Your doctor may recommend hand rehabilitation therapy or physical therapy to improve function, strength and reduce stiffness.

Risks and Complications of Wrist Fracture Surgery

As with any procedure, wrist fracture surgery involves certain risks and complications. They include:

• Infection
• Residual joint stiffness
• Arthritis

Wrist Fracture

Fractures of the Hand and Fingers

The hand is one of the most flexible and useful parts of our body. Because of overuse in various activities, the hands are more prone to injuries, such as sprains and strains, fractures and dislocations, lacerations and amputations while operating machinery, bracing against a fall and sports-related injuries.

Fractures

A fracture is a break in the bone, which occurs when force greater than the bearable limit is applied against a bone. The most common symptoms of any fracture include severe pain, swelling, bruising or bleeding, deformity and discoloration of the skin and limited mobility of the hand.

Finger fracture

Fingers are fine structures of the human body that assist in daily routine activities through coordinated movements. Any abnormality affecting the fingers can have a huge impact on the quality of life. A finger fracture is not a minor injury, and if left untreated, can lead to stiffness, pain, disruption of the alignment of the whole hand and interference with specialized functions such as grasping or manipulating objects. Finger fractures commonly occur during sports activities, when you break a fall or while operating machinery.

Diagnosis

The diagnosis of a hand or finger fracture is based on history, physical examination and X-ray imaging to determine the type and severity of the fracture. X-rays are the most widely used diagnostic tools for the evaluation of fractures.

Treatment

The objective of early fracture management is to control bleeding, provide pain relief, prevent ischemic injury (bone death) and remove sources of infection such as foreign bodies and dead tissues. The next step in fracture management is the reduction of the fracture and its maintenance. It is important to ensure that the involved part of the body returns to its function after the fracture heals. To achieve this, maintenance of fracture reduction with immobilization technique is done by either non-operative or surgical methods.

Non-operative Therapy

The bones can be realigned by manipulating them into place. Following this, splints, casts or braces made up of fiberglass or Plaster of Paris material are used to immobilize the bones until they heal. The cast is worn for 3 to 6 weeks.

Surgical Therapy

During surgery, the fracture site is adequately exposed, the bones realigned and reduction of the fracture is done internally using wires, plates, screws and intramedullary nails.

Rehabilitation

Fractures may take several weeks to months to heal completely. You should limit your activities even after the removal of the cast or brace so that the bone becomes solid enough to bear stress. Rehabilitation program involves exercises and gradual increase in activity levels to strengthen the muscles and improve range of motion.

Finger Fractures