Treatment for wrist fracture

It is usually obvious to the patient following a fall once a fracture of the wrist has occurred, the wrist joint is usually very painful and swollen and it may of course be deformed. Immediate treatment consists of resting the painful part (for example in a sling). The use of something cold will help control swelling, ice or frozen peas are suitable but they should always be wrapped in something (e.g. a towel) and NEVER applied directly to the skin. This is because direct contact with ice may cause skin damage to occur.

Medical advice should be sought immediately and it is important to remember that the patient may require an anaesthetic for treatment of these fractures and it is therefore important to avoid food and drink until a Doctor or other Medical Practitioner has seen the injury so as to avoid a delay in treatment.

Almost always an X-ray (radiograph) of the wrist is required to make an accurate diagnosis of wrist fractures and to decide upon the correct treatment. Figure four shows the typical appearance of a wrist fracture (in this case a COLLES’ fracture). This X-ray shows that the radius has both bent and moved away from the palm. It is this movement (what Orthopaedic surgeons call angulation and displacement) which causes the dinner fork deformity.

There are three parts to the treatment of a fracture of this sort, firstly to reduce the fracture, that is to put the two parts of the fracture back to their original position. Once the fracture is reduced, it needs to be kept in the correct position until the bones have a chance to heal, this on average takes about six weeks. The third part of fracture treatment is to ensure that the soft tissues of the arm are kept mobile until the arm can get back to its original use.

There are many methods of treatment for fractures of the wrist and it is true to say that Orthopaedic surgeons are undecided as which method of treatment is best. The particular method of treatment will depend both upon the preference and experience of the surgeon and will also depend upon the nature of the fracture. Most surgeons will use a variety of methods to treat fractures of the wrist. It is also worth saying that traditionally treatment of these fractures has been guided by the statement of COLLES in his original paper who said that people with these fractures do well even if the fracture isn’t reduced. This has meant that these fractures have tended to be under treated in the past although most Orthopaedic surgeons now realise that treatment of these fractures is important if later problems are to be avoided.



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