Hand and Wrist Fractures
AT BEL AIR CENTER FOR PLASTIC AND HAND
Fractures in the hand and/or wrist are very common in men and women at nearly every age. This is often due to landing on outstretched hands in a fall. These injuries typically involve several different bones, not just in the wrist but also in the arm. Fractures can cause a lot of immediate pain, and can affect range of motion and grasping function.
The wrist is one of the most complex joints in the body, so wrist fractures often involve a lot of different bones at once. These typically include the tiny bones at the base of the hand, called carpal bones. A fractured wrist causes almost immediate pain and tenderness. These decrease, and then worsen, when pressure is applied between the tendons that connect to the thumb. Bruising and swelling are also common symptoms of a hand or wrist fracture. In some cases, your wrist may look bent or hang differently. Making a fist can be challenging with a wrist fracture as well. It’s common for wrist fractures to include additional damage such as ligament injury, wrist sprains or dislocation.
The two large bones in the forearm, the radius and the ulna, can also be affected by a wrist fracture. The radius runs along the thumb side of the forearm, while the ulna is on the outer side of the forearm. Fracture of these larger bones can cause the hand and wrist to go out of alignment.
When finger bones are fractured, the finger is hard to move and feels very painful. The affected digit feels tender and often looks swollen. Sometimes the finger looks shorter or even deformed, and the fingers may cross each other incorrectly when you try to make a fist.
The most common place for a wrist fracture to occur is right at the wrist end of the radius bone. This is called a distal radius fracture, and accounts for more than 15 percent of emergency room visits for broken bones. The reason that the distal fractures are so common is because that end of the radius makes up the vast majority (almost 80 percent) of the surface of the wrist joint. During a fall, this area will bear the brunt of any force upon landing.
Understanding Hand and Wrist Fractures
The first step to determine the appropriate level of treatment is to take X-rays in order to find out the extent of any damage. Sometimes, an MRI or CT scan may be needed as well. The location of the fracture, the presence of bone fragments and the fracture position and stability are all taken into consideration when treatment is decided.
A lot of wrist fractures can be treated effectively without any form of surgery. If there are bone fragments, these are replaced back into their original position. The wrist (or hand or finger) is placed into a supportive cast or specially fabricated splint for stability during the healing process. Hand therapy plays an important role in the healing process after the cast or brace is removed.
More significant fractures require surgery for proper healing; this can occur for a number of different reasons. For example, a very unstable fracture makes repositioning any bone fragments impossible, because they won’t stay in place. An individualized approach toward treatment is necessary to ensure optimum healing.
Recovery and Results
Recovery after hand surgery occurs gradually and depends on the nature of the injury. Some men and women feel stiffness in their hands and wrists, while others may notice loss of motion. The majority of hand and wrist fractures heal very well. Patients resume light activities a few months after surgery, with more vigorous activities waiting until the hand and wrist are strong again.
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