Wrist Injury : Sprains and Fractures

The wrist is one of the most commonly injured joints in a fall. Wrist fractures are seen often in children [and adults] who fall on an extended hand.

WRIST FRACTURE refers to a break in one or more of the bones in the wrist. The wrist is comprised of 10 bones; 8 hand bones (carpals) and 2 forearm bones (radius and ulna). The most common fracture involves the RADIUS (the largest bone in the wrist joint, extending up to the elbow). The RADIUS makes up the "thumb side" of the wrist joint. A common fracture that occurs in children is the Colle's fracture of the wrist. In this case, the wrist will be "bent" upward due to displacement and angulation at the fracture site (see below).

A WRIST SPRAIN refers to a tearing injury to the ligaments which stabilize the bones of the wrist joint. Some of the most disabling injuries of the wrist are due to ligament tears, making the medical evaluation of this problem very important. Common symptoms of both wrist FRACTURES and SPRAINS are pain and swelling in the joint. Fractures can also cause point tenderness, pain while at rest, and deformities. Both injuries can cause pain when attempting joint motion, lifting, or grasping. Evaluation of the injured wrist includes examination for tenderness to palpation, deformity, swelling, potential nerve injury, and vascular integrity (pulses, pink nail beds, feeling and movement in each finger). In most cases, bone x-rays will disclose fractures, and aid the physician in determining the best course of management.

Treatment of fractures that are severely DISPLACED may heal only after surgical intervention. Fractures, like the Colle's fracture, that are markedly ANGULATED (a "bend" to the site), will require IMMEDIATE manipulation (reduction) and cast application. Most uncomplicated fractures are treated with an IMMEDIATE initial splinting, followed by the application of a circular cast [within several days] for approximately 6 weeks. Some patients may require the use of a light brace for an additional 2-3 weeks. Elevation of the injured extremity will help reduce swelling. Ice packs should be used for the first 24 hours. Acetaminophen, aspirin, or anti-inflammatories are used for pain control without the side effects of sedation. Any development of fingertip numbness, pain, or bluish discoloration requires PROMPT RETURN to the physician for re-evaluation (cast or splint may be too tight).

Treatment for most wrist sprains require rest and immobilization in a wrist splint. An elastic wrap (Ace bandage) may be used when the injury is less serious. Anti-inflammatories (ibuprofen), acetaminophen, or aspirin can be used for pain control. Close orthopaedic follow-up is necessary in all cases of wrist injury to be certain of recovery. Joint stiffness and muscle weakness, after long immobilization in a cast, can be reversed with appropriate physical therapy and exercise. Your Orthopaedic Surgeon can help you with the case management of wrist sprains and fractures.

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12 Human and Animal Bites
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12 Facial Injury Jaw Fracture and Dislocation
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12 Knee Injury Contusion
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12 Stab Wounds
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12 Puncture Wounds
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Abdominal Injury
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Ankle Injury: Contusion
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Back Injury
Back Injury : Sacrococcygeal Injury
Back Strain
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Rib Fracture
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Shoulder Injury: A-C Separation
Spider Bites
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Wrist Injury
hi Scuba Related Injuries
i Hand Injury Finger Amputaion
de Lecerations
de Cold Injury and Hypothermia
dd Dental Injury
xs Facial Injury
sdf Neck Injury
e Shoulder Injury Dislocation
e Ear Injury
ed Elbow Injury
de Elbow Injury Fracture
dfe Elbow Injury Nursemaids
ee Electrical Injury
de Eye Injury
ed Facial Injury General Considerations
fr Facial Injury Contusion
ed Hand Injury Finger Sprains
ded Fingernail and Toenail Injuries
dd Hand Injury Fractures
23 Head Injury Skull Fracture and Concussion
44 Chest Injury Myocardial Contusion
fde Heat Illness
ed Hest Injury Hemothorax
y Back Injury Disc Disease
;l High Altitude Illness

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