The “Broken Wrist” and Distal Radius Fractures
Distal radius fractures resulting in a “broken wrist” is a condition that is common among all age groups. The radius is the most commonly broken bone in the arm, although there are also other injuries which can occur from a fall onto the wrist. A fall onto an outstretched arm is the most frequently reported cause. As patients get older our bones may become osteoporotic, making falls which might have seemed more insignificant lead to more significant injury and fractures. Many distal radius fractures in people older than 60 are typically the result of a fall from a standing position. A broken wrist can also occur in younger healthy bones, if the force of the trauma is severe enough. Typically, this is with a higher energy mechanism such as a car accident, fall from a bike or skateboard or fall from a more significant height.
A broken wrist is quickly self-evident, usually resulting in immediate pain, stiffness of the wrist, tenderness, bruising, and swelling. In many cases, the wrist hangs in an odd or bent way (deformity). These injuries are most frequently treated by orthopedic surgeons with sub-specialty training and hand/wrist surgery, or orthopedic trauma specialists. It is important to be seen quickly as many fractures are potentially treated with surgery and need to be addressed in a timely fashion, typically within the first few days after the injury.
On occasion, numbness can be associated with distal radius fractures. Patient’s may develop numbness to the hand and fingers and are more prone to develop carpal tunnel syndrome both with the injury as well as late sometimes several years after the injury.
If the fracture is considered “stable” without significant displacement or deformity, these injuries may be treated non-surgically with a cast or fracture brace until the bone heals. However, when the break causes a malalignment of the bone it may require realignment of the broken bone fragments to maintain the functional use. Children typically can be treated without a surgical incision and once the bone is properly aligned a splint or cast may be placed on the arm for about 6 weeks until the fracture shows healing. Once the break has healed, physical therapy is usually started to help improve the motion and function of the injured wrist.
In adults, if the fracture shows displacement or deformity surgery may be recommended. Significant progress has been made with regards to surgical treatment for wrist fractures, and patients generally do very well with the modern techniques and technology we have today. The days of external bars and screws have passed and these treatment methods are now only indicated in the most significantly traumatized patients or patients with significant soft tissue injuries. Internal fixation methods used to hold the bones in place is typically accomplished with a small 3–4-inch metal plate and screws to hold the broken fragments in position while they heal. Additionally, after surgery patients are able to bend and move the hand and wrist quicker than they would with cast immobilization.
Most people return to normal activities following a distal radius fracture with no problem. Fracture is generally take around 6–8 weeks to heal, but stiffness associated with them sometimes takes longer to work out. The nature of the injury, the kind of treatment received, and the body’s response to the treatment also means people recover at different rates. But almost all patients experience some stiffness in the hand and wrist which lessens over the first several weeks, and continues to improve for up to 1–2 years after the break.
*Information for this article provided in part by AAOS OrthoInfo. Contributing editor Dr. Mintalucci.
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SRO’s Hand Center specialists provide the most up-to-date, medically appropriate treatment. In combination with our certified hand therapists and medical staff, our physicians offer exceptional quality, in both surgical and non-surgical evaluation and treatment.
Kai-Uwe Mazur, M.D.
Dr. Mazur is the co-director of The Hand Center at SRO and performs the latest techniques in upper-extremity joint arthroplasty/replacement, advanced arthroscopic reconstruction, ligament reconstruction of the upper extremity, tendon repair, vascularized bone grafting, peripheral nerve surgery and microsurgery. Dr. Mazur also provides leading-edge treatment for cumulative trauma disorders and performs minimally invasive surgeries for carpal tunnel syndrome and other overuse disorders. In addition he performs total elbow, thumb basilar joint, finger and wrist replacements and provides PRP (Platelet Rich Plasma injections) to patients.
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Dominic Mintalucci, M.D.
Dr. Dominic Mintalucci is a board certified orthopaedic hand surgeon with subspecialty fellowship training in microsurgical hand, wrist and elbow surgery. Dr. Mintalucci has published several articles, presented at national hand and orthopedic surgical conferences, textbook chapter author, and has been involved in several research projects. He is the Co-Director of The Hand Center at SRO for over seven years. He has been trained in the most advanced and up-to-date surgical techniques, including minimally invasive surgical techniques, mini-open, and arthroscopic and percutaneous techniques.
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