Everything You Need to Know About Wrist Fractures
July 21st, 2016 1:25pm
If you've suffered a hard fall or a blow to the wrist and are now facing treatment and recovery for a wrist fracture, you might be a little intimidated by the road ahead. Especially if you've never broken a bone before. But have no fear, this article is specifically designed to educate you about the situation -- from injury all the way through to full recovery. And if we do our job right, you'll feel a little better and be a lot more informed when you're done reading.
The Distal Radius Fracture
Your forearm is made up of two bones that are joined together at the wrist and at the elbow. These two bones are called the radius and the ulna. The technical name for fracturing the larger of the two forearm bones in your wrist is the distal radius fracture. This larger bone is the radius, and the word "distal" refers to the lower portion of the bone located nearest to your hand.
In the medical world, there are also a few different terms used to classify the type of fracture suffered. The first two classifications are articular (also called intra-articular) and extra-articular.
In an articular fracture, the fracture itself extends to the end of the radius bone and into the wrist joint. Extra-articular fractures are just the opposite. These are fractures to the radius that do not extend into the joint area.
From there, fractures are further categorized according to how severe the break in the bone is. If the fracture has gone all the way through and pieces of the bone are now separated from each other, this is called a displaced or an unstable fracture. These fractures threaten the structure of the wrist itself and are more serious in terms of treatment and recovery. If the break has not separated any fragments from the bone, it is commonly called an undisplaced or stable fracture.
The last type of fracture we'll talk about here is the open fracture. In an open fracture, the broken bone has pierced the skin and is susceptible to infections, bacteria, and blood loss. This is a serious situation that requires immediate attention. If you've suffered an open fracture, you should get to an emergency room right away.
The first step to take if you think you've suffered a wrist fracture is to see a doctor and get your situation diagnosed. Many patients will choose to head to the emergency room or call their primary care physician, but Excelsior offers an Express urgent care clinic that we highly recommend to fracture patients. Hospitals and primary care physicians may help diagnose you and provide you with some medication for the pain, but ultimately they will refer you to an orthopaedic specialist for imaging and further treatment (which we'll talk about in a minute).
These are areas that we specialize in here at Excelsior, so we can get you diagnosed, x-rayed, treated and on your way all in one trip, saving you from expensive emergency room bills.
Treatment and Recovery
After your fracture is properly diagnosed, your doctor will talk to you about recommended treatment options based on the type and severity of your injury. Less severe fractures, such as stable, undisplaced break, will often be treated by casting and immobilization. In more serious and unstable fractures, surgical options may be recommended or required. Let's take a look at the different paths to recovery.
Casting is an option available to fracture patients whose bones are still close enough in place to allow for proper healing. Sometimes a doctor may need to realign the bones, which is called reduction.
After the bones are returned to the correct position, a splint or cast can be applied that will immobilize the wrist. This will have to be worn for several weeks as the bones heal, and frequent checkups may be needed to assure that the bones are still aligned in the correct position. In displaced fractures, the non-surgical method of treatment can often get complicated because of moving bones, even when immobilized with a cast. This is something you and your doctor will discuss in further detail as you weigh your potential treatment options.
Recovery from a casted fracture will typically have a timetable of several months. The cast is usually removed after 4-6 weeks, and then a therapy regimen is necessary for 4-12 months to help rebuild strength and mobility in the wrist and forearm. During this time, some pain and stiffness in the joint and surrounding areas is common.
In the long term, some patients who suffer a distal radius break and choose the non-operative path may face chronic pain, stiffness, and the development of arthritis in the joint as time passes.
If the fracture is unstable, displaced, or otherwise severe, patients may choose or require surgical treatment to hold the bones in place throughout the healing process.
This has traditionally been accomplished by the use of plates, screws, or pins to hold bones and fragments in place. These surgeries offer an array of options for fixation of the bones, and each has pros and cons depending on the individual fracture situation. This image details some of the surgical options available to patients with displaced or unstable fractures.
Using surgical treatments can provide greater immediate mobility than casting treatment, but the long-term recovery timetable looks similar to that of casting. While driving and some less vigorous activity may be possible a few weeks after surgery, patients will still experience pain and stiffness in the joint and likely will need upwards of a year to fully recover.
Broken bones are a serious injury no matter how they're treated, and getting back to life completely free of pain and stiffness can take a long time.
The Conventus Cage
A final option for treatment of distal radius fractures is a new surgical implant called the Conventus Cage. Developed by Conventus Orthopaedics, the Cage is a new surgical option that is improving significantly on previous treatment techniques.
Instead of attaching hardware to the outer part of the radius to keep the bone in place, the Cage is inserted inside the bone and is then expanded outward to achieve proper alignment of the fracture. This allows for a more minimally-invasive surgery that reduces complications and accelerates recovery time for patients. The video below further explains how the Cage works.
Patients choosing the Cage often see their recovery time cut by as much as 50%, and some are even able to drive after only 2 weeks from surgery. The strides being made in this area of treatment are huge, and doctors and patients alike are beginning to see how much better the Cage can be when compared to traditional recovery and treatment methods.
The road back to full health can still be a long one, but early indications show that Cage patients experience less pain and stiffness with a faster return to normal function.
Making The Right Choice
Suffering an injury as severe as a wrist fracture is never easy, so it's important to fully understand all the options available to you as a patient. Our team at Excelsior just wants you to make the right choice for yourself, so our doctors and staff are here to diagnose your injury and review your options any time you're ready to make an appointment.
For more information about distal radius fractures and the treatments mentioned in this post, check the links below for further reading: