Fractures of the distal radius (wrist)
Wrist fractures are common. In adolescents and young adults they tend to occur after quite significant trauma, such as a fall off a bicycle or while snowboarding, onto an outstretched hand. As we get older, wrist fractures can also occur after a simple trip and fall, and may be associated with osteoporosis.
How wrist fractures are treated will depend on a number of factors, including:
- How displaced the fracture was at the time of injury, and how displaced it remains after any treatment that has been carried out
- How fragmented (comminuted) the bone has become
- The presence of any associated injuries, such as to nerves, ligaments, or other bones in the wrist
If the bone is fractured, but the main fragments are not displaced, it is often possible to treat the injury with a cast from just below the elbow to the base of the fingers for a period of 4 to 6 weeks. If however there is displacement present, that is likely to affect healing or function of the wrist in the long term, then one of the following treatments may be required:
- Manipulation of the fracture under anaesthetic and application of a cast
- The insertion of temporary wires through the skin and across the fracture to stabilise it ("k-wiring").
- Increasingly, the application of a plate and screws onto the bone ("open reduction and internal fixation"), which usually will remain in place permanently, even though the fracture heals fully within 3 months. Rehabilitation of the wrist can often start within 2 weeks of surgery if this technique is used.
- Rarely, the application of an external frame connected to pins that are inserted into the hand and the forearm ("external fixation"). This is then removed after 6 to 8 weeks.
Mr Gidwani will be able to explain the appropriate treatment options to you, as well as their advantages, disadvantages and potential risks. As with the treatment of any broken bone, the aim is to encourage the bone to heal in a position that enhances recovery, and to enable appropriate therapy so that in time you can regain good function of the hand and wrist.