A fractured wrist occurs when one or more of the bones in your wrist shatter or crack. When someone tries to catch oneself during a fall and lands forcefully on an outstretched hand, they most frequently injure their wrist.
If you engage in activities like in-line skating or snowboarding or have a medical condition that causes your bones to thin down and become more brittle, you may be more likely to break your wrist (osteoporosis).
A fractured wrist has to be treated as quickly as possible. Otherwise, it’s possible that the bones won’t mend properly, which might make it difficult for you to do daily tasks like writing or buttoning a shirt. Early intervention will also lessen discomfort and stiffness.
Cause of wrist fractures
A distal radius fracture is most commonly caused by a fall onto an extended arm.
A very modest fall can result in a fractured wrist due to osteoporosis, a condition that is common in older persons and causes bones to become extremely weak and more prone to breaking. A fall from a standing posture is the main factor in the development of distal radius fractures in adults over the age of 60.
If the power of the impact is significant enough, a fractured wrist can occur even in bones that are in good health. For instance, a young, healthy individual might break their wrist in a vehicle accident or by falling off a bike.
Having healthy bones may help older patients avoid fractures. People with a history of osteoporosis should discuss their choices for bone strengthening with their primary care physician.
Symptoms of wrist fractures
The wrist is swollen, uncomfortable, and sensitive. When the median nerve is injured, the tip of the index finger becomes numb, and patients may struggle to press their thumb and little finger together.
A wrist fracture can cause stiffness, chronic discomfort, and/or osteoarthritis, especially if the fracture extends into the wrist joint if the fractured parts are misaligned.
Types of wrist fractures
Distal Radius Fracture
The radius and ulna, two forearm bones that make up the wrist, are the bigger of the two. A distal radius fracture is a break in the radius bone near the wrist, where it is more prone to injury. A distal ulna fracture refers to when the ulna bone in the forearm is also shattered.
The most frequent kind of wrist fracture, a distal radius, is frequently brought on by a fall onto an extended arm. The distal radius can fracture in a variety of forms, and in order to successfully treat a fracture it is crucial to identify its kind. Distal radial fractures that extend to the wrist joint or breach the skin, for example, can be challenging to cure.
The scaphoid is one of the carpal bones, which are tiny circular bones that are arranged in two rows at the wrist, close to the base of the thumb. The second-most frequent form of wrist fracture is a scaphoid fracture, although diagnosing and treating one can be challenging. They can come from injuries sustained during sports and car accidents, but they frequently happen as a consequence of trauma, such as when a person reaches out to break a fall.
Treatment options are available, and the likelihood that nonsurgical methods, including utilising a cast, would be successful increases the closer the break is to the thumb. The healing process is more challenging the further away the break is from the thumb because there is less blood flow there, which is necessary for healing. Surgery can also be required.
Some less common wrist fractures
- A Barton’s fracture is a distal radius fracture with a radiocarpal (wrist) joint dislocation. Barton’s fracture is frequently repaired surgically.
- The radial styloid (the bulge at the end of the radius bone towards the base of the thumb) is fractured in a Chauffeur’s (Radial Styloid) Fracture. It is typically caused by a direct strike to the radius and frequently necessitates surgery.
- A Styloid Ulnar Fracture occurs when the styloid bulge at the end of the ulna bone is broken. The noticeable protrusion on the outside of the wrist is the ulnar styloid. This fracture is frequently associated with a distal radius fracture as a consequence of a fall and may necessitate surgery.
Diagnosis of wrist fractures
If the injury is not very severe and the wrist is not distorted, you may be able to visit a doctor the next day. A splint can be used to protect the wrist. An ice pack can be placed on the wrist, and it can be raised until a doctor can check it.
If the injury is extremely painful, the wrist is significantly distorted, or the fingers are numb or pallid, go to an urgent care center or emergency room right away.
The doctor will most likely request wrist X-rays to confirm the diagnosis. X-rays can reveal if the bone is shattered or displaced (a gap between broken bones). They can also reveal how many shattered bone bits there are.
A computed tomography (CT) scan, which produces 3-D images of the shattered bone, may be ordered in some situations by the doctor. This can be useful in surgical planning.
Treatment of wrist fractures
The treatment of shattered bones follows a simple rule: the broken pieces must be repositioned and stopped from moving until they recover.
A distal radius fracture can be treated in a variety of ways. Many variables influence the decision, including the type of the fracture, your age and activity level, and the surgeon’s best opinion.
Sometimes the bone position cannot be rectified with a closed reduction alone and/or cannot be maintained in a cast. These fractures may heal out of alignment, resulting in impaired arm function. In such circumstances, surgery may be required to repair the fracture and stabilize it while it heals.
Procedure – To reach the shattered bone, an incision on the wrist over the fracture is often made (s). Important structures including arteries, nerves, and tendons are recognised and safeguarded. The shattered bone(s) are realigned immediately via the incision by the surgeon. This is often referred to as an open reduction.
There are several ways for retaining the bone in the right position as it heals after it has been realigned, depending on the fracture:
Cast – Casts are rarely utilized following an open reduction.
Metal pins (typically stainless steel or titanium) – This therapy was popular many years ago and is currently commonly used in youngsters with developing bones.
Plate and screws – The most common surgical treatment option for distal radius fractures.
External fixator (a stabilizing structure outside the body that holds the bones in place so they may heal) — This has become less popular in recent years, but it is still a viable option for severe and open fractures.
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