Pediatric Orthopedic Surgeons treating a Broken Wrist

BROKEN WRIST

A broken wrist is a crack or break in the bones of your wrist. Most commonly, these injuries occur in the wrist when an individual tries to hold himself during a fall and land hard on an extended hand.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Broken Wrist

A broken wrist is a crack or break in the bones of your wrist. Most commonly, these injuries occur in the wrist when an individual tries to hold himself during a fall and land hard on an extended hand. If you participate in sports like in-line skating or snowboarding, you may be at higher risk of breaking a wrist. Also, if you have osteoporosis, you are prone to develop a condition like this.

It’s crucial to treat a broken wrist asap. Or else, the bones might not heal in proper alignment, affecting your capability to do daily activities such as writing or buttoning up a shirt. Quick treatment will also help deal with the pain and stiffness.

Description

A distal radius fracture is more likely to occur about 1 inch from the edge of the bone. It is a common fracture occurring in various forms in people of different age groups. In young individuals, fractures like these usually occur in high-energy accidents such as a fall from a ladder or a vehicle crash. In older men and women, especially those with osteoporosis, these fractures can occur from a simple fall onto the wrist.

A Colles fracture is among the most common distal radius fractures. In this type, the broken fragment of the radius tilts upward. Abraham Colles, an Irish surgeon, and anatomist, first described this fracture in 1814. That is why its name is Colles fracture.

Different Ways The Distal Radius Can Break:

  • Intra-articular fracture —  This one happens in the wrist joint.
  • Extra-articular fracture —  It is a fracture that does not expand in the joint.
  • Open fracture —  It is an open fracture when a fractured bone breaks the skin. These fractures need immediate medical attention because they may lead to infections.
  • Comminuted fracture —  When a bone breaks into more than two pieces, it is a comminuted fracture.

It is crucial to categorize the type of fracture since, in open fractures, comminuted fractures, intra-articular fractures, and displaced fractures, the broken pieces of bone do not line up. That is why these are more difficult to treat than other fractures.

Sometimes, the other bone, the ulna, also gets broken. It is called a distal ulna fracture. Considering the type of distal ulna fracture, you may or may not need additional treatment.

Broken Wrist Causes 

The common cause of a distal radius fracture is when a person falls onto an extended arm. Especially when you have osteoporosis, even a comparatively minor fall can cause a broken wrist. In most cases, distal radius fractures in people over 60 happen from a fall from a standing posture.

If the force of the trauma is severe enough, a broken wrist can even happen in healthy bones. For example, in a young and healthy person, a vehicle accident or a fall from a bike may cause enough force to break a wrist. Older patients with good bone health can potentially prevent fractures. People who have a history of osteoporosis should consult an orthopedic doctor regarding options for bone strengthening.

Broken Wrist Symptoms

A broken wrist generally causes immediate pain, bruising, tenderness, and swelling. In many cases, the wrist may be deformed for the fracture such as the wrist hanging in an odd or bent way. In severe fractures, the injury affects the nerve(s) in the hand. This may cause numbness in the fingers. If you have numbness in your fingers after getting your wrist injured, immediately go to an urgent care center or emergency room. You should address the injury ASAP to prevent permanent nerve damage.

Doctor Examination

If the injury is not highly painful and the wrist does not have any deformity, you may wait until the next day to see an expert. You can protect the wrist with a splint. Also, applying an ice pack can to the wrist and keeping it elevated until a doctor examines it will be really helpful. If the injury is extremely painful, the wrist deformity is severe, or if your fingers feel numb or pale, go to an urgent care center or emergency room to get the right treatment.

To do an accurate diagnosis, our doctors will recommend X-rays of the wrist. X-rays can help demonstrate if there is a broken bone or if there is a displacement between the broken bones. An X-ray can also show the number of broken bone pieces. In certain cases, our doctor may also recommend a computed tomography (CT) scan. This will provide 3-D pictures of the broken bones. This can further help with planning the right surgery.

Broken Wrist Treatments

The basic rule of treating broken bones is that the broken pieces need to be put back into the right position and should be prevented from moving out of place until bone healing occurs. There are various treatment options available for a distal radius fracture. Our doctors will determine the right treatment depending on various factors. For example, the nature of the fracture, the patient’s age, activity level, etc.

Nonsurgical Treatment

If the broken bone is in a proper position, doctors may apply a cast until the bone heals. If there is a displacement of the broken bone and it restricts the future use of your arm, it may be crucial to re-align the broken fragments of bones. With the word reduction, doctors technically describe the process in which they move the broken pieces back into place. The procedure of straightening a bone without cutting open the skin (incision) is known as a closed reduction.

Surgical Treatment

Sometimes, a closed reduction may not help position the bone in the correct way. If not placed properly, these fractures may heal in bad alignment resulting in poor function of your arm. In such cases, you may need surgery to improve the fracture and get it back in place while it heals.

  • Cast — Casts are hardly used after an open reduction.
  • Metal pins – This treatment was common several years ago. And it is still frequently used in treating broken wrists among children with growing bones.
  • Screws and Plates — This is the most common option in terms of surgical treatment for distal radius fractures.
  • External fixator – In this procedure, doctors use a stabilizing frame outside the body to hold the bones in an accurate position while they can heal. Even though this has become less common in recent years, it is an effective option to heal severe and open fractures.
  • If required, doctors may also use any combination of these techniques.

Open Fractures

For most open fractures surgery is necessary as soon as possible generally within 24 hours or less after injury.

  • Doctors carefully clean the exposed soft tissue and bone and then give antibiotics to prevent infection.
  • Experts use external or internal fixation methods to hold the bones in place.
  • If there is severe damage to the soft tissues in the fractured area, doctors may use a temporary external fixator.
  • Doctors often recommend Internal fixation with plates or screws at a second procedure after several days when swelling reduces and the soft tissues around the fracture are back in form.

Since there are various kinds of distal radius fractures, and the treatment options are wide-ranging, recovery will be different for everyone. Come and talk to our orthopedic doctors for particular info about your recovery program and how fast you can return to daily activities.

Call 214-556-0590 to make an appointment.

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