Hand & Wrist

Hand Fractures

Treatment

The objective of early fracture management is to control bleeding, provide pain relief, prevent ischemic injury (bone death) and remove sources of infection such as foreign bodies and dead tissues. The next step in fracture management is the reduction of the fracture and its maintenance. It is important to ensure that the involved part of the body returns to its function after the fracture heals. To achieve this, maintenance of fracture reduction with immobilization technique is done by either non-operative or surgical methods.

Non-operative Therapy

The bones can be realigned by manipulating them into place. Following this, splints, casts or braces made up of fiberglass or Plaster of Paris material are used to immobilize the bones until they heal. The cast is worn for 3 to 6 weeks.

Surgical Therapy

Duringsurgery, the fracture site is adequately exposed, the bones realigned and reduction of the fracture is done internally using wires, plates, screws and intramedullary nails.

Rehabilitation

Fractures may take several weeks to months to heal completely. You should limit your activities even after the removal of the cast or brace so that the bone becomes solid enough to bear stress. Rehabilitation program involves exercises and gradual increase in activity levels to strengthen the muscles and improve range of motion.

Wrist Fracture

Your doctor may prescribe analgesics and anti-inflammatory medications to relieve pain and inflammation.

Fractures that are not displaced are treated with either a splint or a cast to hold the wrist in place.

If the wrist bones are displaced, your surgeon may perform fracture reduction to align the bones. This is performed under local anesthesia. A splint or a cast is then placed to support the wrist and allow healing.

Surgery

Surgery is recommended to treat severely displaced wrist fractures and is carried out under the effect of general anesthesia.

External fixation, such as pins may be used to treat the fracture from the outside.

These pins are fixed above and below the fracture site and are held in place by an external frame outside the wrist.

Internal fixation may be recommended to maintain the bones in proper position while they heal. Devices such as rods, plates and screws may be implanted at the fracture site.

Crushed or missing bone may be treated by using bone grafts taken from another part of your body, bone bank or using a bone graft substitute.

During the healing period, you may be asked to perform some motion exercises to keep your wrist flexible. Your doctor may recommend hand rehabilitation therapy or physical therapy to improve function, strength and reduce stiffness.

Risks and Complications

As with any procedure, wrist fracture surgery involves certain risks and complications. They include:

• Infection
• Residual joint stiffness
• Arthritis