Wrist Fracture: Complications & Treatment

In this video SimpliHealth expert Orthopaedic joint and Spine replacement Surgeon Dr. MS Narula is talking about Wrist fracture.

Wrist Fracture/कलाई की हड्डी का टूटना

The wrist fracture most commonly occurs in the radius bone. Here (forearm) has two bones, one small bone (ulna) and one larger bone (radius), so the larger portion of the radius bone close to the wrist gets fractured. And mostly, the history of the injury is that we had a fall with our outstretched hand. 

Like when we fall, we stop ourselves by keeping our hands stretched to cushion a fall on the ground. So all the impact comes around the wrist, due to which there is pain and swelling in this region. There is the history of fall on an outstretched hand and a patient comes to us with swelling and pain around the wrist joint, also known as a distal radial fracture.

So roughly, they are of two types:  extra-articular and intra-articular. Extra-articular happens little above the wrist joint whilst intra-articular fractures the bones inside the wrist joint. So accordingly, we plan the treatment.

Wrist Fracture Treatment

Usually, the patients come with pain and swelling in the wrist with no movement or a very slight movement in the wrist. And the patient holds the wrist with the other hand. This fracture can easily be diagnosed on the plain X-Ray when we do the X-ray we see the wrist bone fracture on the slight upper side of the radius bone.

Most of the fractures are managed with plaster in the initial treatment. After we do an x-ray, we diagnose it, and if we see that there is no intense pain and swelling the plaster is reduced at this stage

How to treat these radius fractures? 

As our experts told you before, the treatment will depend upon whether the fracture is inside the joint or outside the joint, age of the patient. The condition of the patients’ bone, and most importantly, the amount of displacement that has happened due to the fracture. 

How much is this fracture displaced from its original position? 

Please remember that this fracture commonly happens in postmenopausal women after 45 years, especially those with osteoporotic bones. So this fracture is most commonly seen in weak bones. Naturally, weak bones take more time to heal. So it depends on the X-ray report that shows the extent of displacement or nondisplacement. If it is undisplaced, that means it has not moved not much from its original position. So most of these fractures can be managed by simple plaster.

In many cases, this plaster can be given under anesthesia. If we think we need to set it a little bit or reduce it a bit, otherwise we immobilise these fractures in the OPD practices with the plaster, i.e., POP cast. Most of these fractures heal well with the pop cast in 4 to 6 weeks, followed by good physiotherapy to avoid wrist stiffness. And in a few cases where the fracture is displaced and has moved farther away from its original position, we recommend the operative method. 

In operative, if the fracture is not much displaced, we simply reduce it by putting some wires followed by plasters on it but yes, in a few cases, where the fracture is inside the joint a plate is put because we wish that it sticks to its original position as much as possible because it is better for the wrist movement If it joins wrongly it will lead to restriction in the wrist movement and may lead to stiffness and a weak grip. 

So we wish that if it is a joint fracture, it should join as much as in its original anatomic position as possible. if we can achieve it with that plaster good enough. A proper surgery is performed and we insert a special plate in it too. The patient is in the hospital for one or two days, and the movements start after 4 to 6 weeks.

Most of these  fractures heal very well. Of course, you have to treat your osteoporosis. You need to have calcium and Vitamin D supplements and start the mobilisation as early as possible, sometimes as early as three weeks, and in some cases, we may delay it for six weeks. 

So please remember if you have a history of falls and have sudden pain and swelling in the wrist. do not ignore it could be a simple soft tissue injury, but if it is a distal radial fracture, it needs a plaster or surgery, which your orthopaedic surgeon will recommend. Thank you