Wrist fracture - Broken wrist (manipulation, wiring or external fixation)

If you are interested in learning about broken wrist treatment, the following information will interest you.

If you are considering having surgery for a broken wrist (wrist fracture) or have an operation planned, it is important to know all you can about it. This includes:

• why you need this operation

• what it will be like

• how it will affect you

• what risks are involved

• any alternatives.

The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things when treating a broken wrist, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your choice of treatment for a broken wrist (wrist fracture) with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.

What is the problem?

Your wrist is broken. A break is also called a fracture. There is no difference in severity between a fractured bone and a broken bone. Therefore your injury may be called a fractured wrist.

What bones make up the wrist?

You have broken the lower ends of one or both of your forearm bones. These bones are the radius on the thumb side and the ulna on the little finger side of your wrist. This break is usually as a result of a fall on to the wrist.

What has gone wrong?

A fractured wrist usually follows an injury. Usually, the greater the force of the injury, the more serious the fracture.

The broken ends of bone may be undisplaced; still in their correct place, or out of place; displaced.

The aims

The aims are to perform a reduction, which means to get the broken ends of the bone back into place, and to hold them in place while the fracture heals. For you, this means an operation. This will make the bones join as normally as possible. Depending on the severity of the break they will be held with plaster, pins or by using an external frame.

The benefits

Operating on the wrist reduces the risk of arthritis at a later date to a minimum.

Are there any alternatives?

The decision to treat a wrist fracture with surgery depends on the nature of the fracture. In some cases it is better to operate on the fracture and treatment in a cast alone is not the best option.

What if you do nothing?  

If you have no treatment at all, a displaced fracture will heal in the wrong position (mal-union), with an ugly swelling of the wrist.

If the fracture runs into the joint, you may also develop arthritis in the wrist within a year or two. Arthritis would make the affected joint inflamed and painful.

Who should have it done?

If your wrist is broken and needs an operation, and you are fit enough to undergo surgery, you ought to have the fracture fixed.

If you are fit enough for surgery, you ought to have the fracture fixed if:

• The fracture is displaced
• The fracture runs into the wrist joint
• Manipulation and plaster cast have failed

Who should not have it done?

If you suffer major medical problems, then it may be best not to have an operation and have non-surgical treatment instead. 

Author: Mr Boyd Goldie MBBS FRCS BSC DHMSA. Consultant in orthopaedics & trauma.

© Dumas Ltd 2006

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