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Wrist Fractures


Your wrist is an intricate joint, composed of 10 separate bones. When you break one of these bones, it can cause immense discomfort and limited hand movement. Wrist fractures are relatively common, but there are many different types of breaks. Because of the complexity of your wrist anatomy, a fracture can affect blood flow in your arm. Therefore, you should seek treatment from an experienced physician like Gregg A. Vagner, M.D. as soon as possible. Depending on the extent of your injury, wrist fracture treatment at our Austin, TX, practice may involve a simple brace or cast. However, in more severe cases, you may require surgery and physical therapy to regain strength and mobility. Dr. Vagner will always recommend the most conservative treatment, and he will provide ongoing care during the recovery process.

Wrist Fracture Overview

Dr. Vagner explains wrist fracture types, symptoms, and treatments, including surgery.

A Closer Look at Wrist Fractures

The two primary bones in the wrist are the radius and the ulna. At the base of these bones are eight small carpal bones. A wrist fracture can occur in any of these bones, though the radius is the most commonly broken. Distal radial breaks can vary in severity. For example, in a non-displaced break, the bones will not move out of place. In a displaced break, your doctor will need to set the bone, or put it back into its proper position. Some displaced breaks can be more complicated than others. In an unstable break, the bone tends to shift before it heals, even if it is placed in a cast or splint. In other cases, a bone may break into several pieces. Alternatively, it could break off unevenly, giving your joint a rough surface.

Types of Breaks

Because the wrist is comprised of so many bones, there are several different types of fractures that can occur. These include:

  • Distal radius fracture: The most common type of break, a distal radius fracture occurs on the thumb side of the wrist and is typically caused by falling onto an outstretched arm.
  • Scaphoid fracture: The scaphoid bone is located near the base of the thumb. This type of break is among the most common, second to distal radius fractures.
  • Barton’s fracture: This condition is characterized by a distal radius fracture and the dislocation of the radiocarpal joint (located between the forearm and wrist). In most cases, a Barton’s fracture requires surgery.
  • Radial styloid fracture: This type of break occurs in the radial styloid, near the base of the thumb. It is commonly referred to as a chauffeur’s fracture because a wrist break from an early automotive hand crank often resulted in this injury.
  • Ulnar styloid fracture: The ulna has a bulge on the end of it. This bulge is referred to as the styloid, and it is visible on the outside surface of the wrist. This type of break often occurs in conjunction with a distal radius fracture and is commonly the result of a fall.

Most often, wrist fractures occur when you fall onto your extended hand. Car accidents, sporting injuries, and similar events can also cause a broken wrist.

Symptoms of a Fractured Wrist

Significant pain is the most common symptom of a broken wrist. Often, discomfort will worsen when you move your fingers, and it will typically be most noticeable right around the fracture itself. Other signs of broken wrist include:

  • Swelling
  • Disfigurement of the wrist, caused by a bone that has moved out of place
  • Limited wrist and hand movement
  • Inability to move your wrist at all
  • Tingling in your fingertips

Diagnosing a Wrist Fracture

Comprehensive diagnostic imaging is essential for confirming a fractured wrist. In addition to traditional x-rays, a CT (computed tomography) scan or an MRI (magnetic resonance imaging) scan may be taken, both of which can help rule out injuries to the surrounding bones and ligaments. These images will also help Dr. Vagner determine the severity of the fracture. After a full assessment, he will recommend appropriate care on a case-by-case basis.

Most often, wrist fractures occur when you fall onto your extended hand. Car accidents, sporting injuries, and similar events can also cause a broken wrist.

Women over the age of 50 who sustain a wrist fracture are encouraged to undergo a DXA (dual-energy x-ray absorptiometry) test. This assessment measures bone density and is effective for detecting the presence of osteoporosis.

broken wrist
Prompt treatment can help you regain comfort and mobility.

Treatment Options

There are several different options for treating a fractured wrist. The method recommended for you will depend on the type and severity of the break. For example, Dr. Vagner can usually treat a simple break with a cast or splint. However, if you have a displaced or unstable break, you may need surgery. Common treatment options include:

Closed Reduction

After administering anesthesia to ensure your comfort, Dr. Vagner manipulates the broken bone fragments into proper alignment without creating incisions or exposing the fracture.

Casting

Once the fracture is reduced, a cast is placed to stabilize the wrist and neutralize forces. During recovery, the cast will be removed and replaced several times to ensure the fracture is properly supported. If the break has been successfully addressed with reduction, then casting may be the only necessary treatment.

Surgical Procedures

Once a fracture occurs, patients have a two-week window before bone healing begins. Dr. Vagner performs several different types of surgeries for wrist fractures, including:

  • Internal fixation: Surgical pins, plates, and screws can be used to stabilize the wrist once the bones are repositioned. This procedure can reduce or eliminate the need for an external device.
  • Percutaneous fixation: Some fractures that are unstable in a cast alone can be treated with the addition of surgical pins. These can be placed through the skin, without creating incisions. Typically, the procedure is performed in an operating room under regional anesthesia and a cast will be placed afterward.
  • External fixation: Severe fractures can be treated with this time-tested method. Small incisions are created on either side of the fracture, and pins are placed to stabilize the bone. Finally, an external frame is connected to the pins to provide support.

Biologic Agents

Regenerative therapy has made great strides in recent years. Biologic agents can enhance bone healing and support the body’s own recovery process. Research indicates that biologics may be able to shorten post-surgical healing times substantially.

Doctor measuring angle of patient's wrist and arm

Accurately diagnosing the type and severity of fracture will allow Dr. Vagner to provide the most conservative treatment.

Recovery following Wrist Surgery

Because there are so many types of wrist fractures, recovery can vary substantially for each patient. Dr. Vagner will provide you with a list of detailed post-operative instructions. However, there are a few general guidelines that will help you enjoy a comfortable and successful healing period.

  • Pain management: Patients can expect some level of discomfort following treatment for a wrist fracture. Over-the-counter pain relievers and cold compresses can help alleviate these side effects. Prescription medication may be provided as well. 
  • Wound care: Surgical incisions must remain dry until the stitches have been removed. Any casts or splints must be kept dry, as well. This can be accomplished by covering the arm with a plastic bag or cling wrap while showering.
  • Physical therapy: In many cases, patients will require physical therapy to restore wrist strength and a full range of motion. Dr. Vagner can refer you to an experienced therapist who will guide you through a carefully chosen series of stretches and exercises. Some patients may begin physical therapy a few days after their procedure. Others will need to wait until their cast is removed. Generally, you can resume light workouts within one to two months following treatment. More strenuous exercises may be resumed between three and six months after surgery.

It is important to note that full recovery is expected to take at least one year. During this time, patients may experience slight pain or residual stiffness.

If you believe that you may have a fractured wrist, it is important to seek immediate care. When you delay treatment, the bones may heal improperly. In turn, your wrist may be disfigured, and you may experience severely limited movement. With Dr. Vagner’s timely attention, you can typically return to all of your normal activities without discomfort.

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Wrist injuries require prompt attention. Contact Dr. Vagner’s office today to receive timely, customized, and highly effective treatment for your fractured wrist. 

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"I am committed to using experience, along with the latest techniques and technologies, to help my patients achieve the full function, mobility, and comfort in their hand, wrist, and arm that they experienced prior to their injury."

Dr. Gregg Vagner

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