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Wrist Injury : Sprains and FracturesThe 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.
|  Hip Dislocation Hip Fracture Insect Stings and Spider Bites Human and Animal Bites Shoulder Injury Fracture Toxic Inhalations and Carbon Monoxide Poisoning Facial Injury Jaw Fracture and Dislocation Kidney Injury Knee Injury General Considerations Knee Injury Contusion Knee Injury Fracture Knee Injury Sprain Stab Wounds Leg Injury Fractures and Contusions Leg Injury Shin Splints Lightning Injury Oral and Tongue Injuries Nasal Fracture or Contusion Neck Injury General Considerations Neck Injury Fracture Neck Injury Spinal Cord Injury Pelvic Bone Fracture Puncture Wounds Chest Injury Rib Fracture Back Injury Sacrococcygeal Injury Scorpion Bites Abrasion Injuries Shoulder Injury Clavicle Fracture Shoulder Injury Strains and Sprains Snakebite Neck Injury Spinal Cord Injury Abdominal Injury Ruptured Spleen Foot Injury Toe Fracture and Sprain Vaginal or Vulvar Injury Drowning and Near Drowning |
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