Wrist fracture treatment
Wrist fracture is full or partial breakage of the wrist bone. One of the most common broken bone injuries, wrist fractures represent approximately 16 percent of all fractures seen in the emergency room. The treatment that may be right for your wrist fracture depends on a variety of factors including age, past and current health, the severity of the breakage and any past reactions to various treatments or medications.
A wrist fracture can make daily living difficult and cause lasting effects if not treated properly. If you think your wrist has been broken either completely or partially, it is important to seek medical attention. To diagnose your injury, your doctor will ask questions about your trauma and perform a physical exam. These tests typically are done to determine the exact location and severity of the breakage:
- X-ray (radiograph) – This is the initial test done to look for a break in the bone. It is done by sending electromagnetic radiation through the hand and wrist area, which produces images of your musculoskeletal structure.
- Computed tomography scan (CT or CAT scan) – A CAT scan is a combination of computers and radiograph imaging and is used to determine if there are smaller pieces from the fracture or dislocations of the wrist bone.
- Magnetic resonance imaging (MRI) – MRIs do not use radiation, unlike X-rays and CAT scans. Instead, you are put in a tube containing a magnetic field. Then, radio waves are directed at the hand and wrist, causing them to vibrate. These vibrations are then translated into a computer-generated image.
A wrist fracture is one of the easiest types of bone breakages to treat without surgery. Typically, a casting method is used to immobilize the bone while it heals. In some cases, the wrist may have come out of alignment when it broke. When this happens, the doctor may use local anesthesia to realign the wrist and put it on the right track for healing.
In some cases, especially among the elderly, a wrist fracture will require surgery. The aim of most wrist fracture surgeries is to help guide the bones back into place and reconnect them. Wrist fractures are almost always treated using one of these three techniques:
- Plate and screws – When surgery is required on the wrist, it is usually due to damage that will not allow the bones to reconnect using a nonsurgical intervention. In these situations, plates and screws may be used to connect the bones that separated during the breakage..
- External fixation – External fixation to realign and guide the bones during recovery is another way orthopaedic surgeons can help bones heal correctly. In these situations an external rod is used to help guide the wrist back to the correct alignment.
- Kirschner wire fixation – In some rare occasions, when the wrist bones shatter, Kirschner wires, or K-wires, are used to repair the breakage.
Much wrist fracture research focuses on treatment methods and the functionality of the wrist joint after breakage. While most people who fracture a wrist make a full recovery, there are many who are left with limited mobility, which can disrupt their daily living. This is particularly true in women over the age of 65 who suffer from osteoporosis and weakened bones.
In a study conducted by Northwestern University, 6,107 women aged 65 and over were identified and monitored over time. Researchers monitored daily activity such as meal preparation, housecleaning, climbing stairs, shopping and getting in and out of a car. None of these women had had prior bone injuries. Throughout the course of the study, 268 experienced a wrist fracture. Those who broke a wrist saw a significant decline in their ability to perform these daily tasks, more so than those who did not break a wrist.
Because of this prevalence of wrist fractures among older women, a focus has been put on various treatments to strengthen bone structure so daily living is not inhibited. One major focus is on selective estrogen receptor modulators (SERMs). While these drugs have proven to help prevent certain fractures, other major bones are still exposed to risk of breakage, so research continues to seek a solution that will help treat the symptoms of osteoporosis while also treating all bone types. As research on hormone therapy is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.
The multidisciplinary team of trauma and wrist experts at Northwell Health Orthopaedic Institute performs wrist fracture surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.