Wrist Fractures Treatment
A fall onto an outstretched hand is the most common way people break a bone, and the wrist is where it usually happens. What breaks depends largely on age. In a younger adult the force typically produces a scaphoid fracture, in an older adult the distal radius gives way first, and in a child the growth plate is the weakest point.
Steven Struhl, MD is board certified in orthopedic surgery and separately in sports medicine, serves as an attending surgeon at NYU Hospital for Joint Diseases and on the faculty of NYU School of Medicine, and has practiced in New York since 1991.
Broken Wrist Surgery and Treatment
If you fracture one or more bones in your wrist, you need an experienced orthopedic surgeon for treatment. Dr. Steven Struhl has spent over two decades in private practice, providing exceptional orthopedic treatment for professional athletes and people from all walks of life. If you suffer a severe wrist injury that includes fractures, Dr. Struhl can perform the needed repairs. Learn more about the most common wrist fractures we treat on the following pages on our website:
Wrist Fracture Symptoms
- Immediate Pain and Swelling: after a fall onto the hand.
- Deformity: the wrist visibly angled, which in a displaced distal radius fracture is described as a dinner fork appearance.
- Bruising: developing over the following days.
- Inability to Bear Weight or Grip: with pain on any attempt to use the hand.
- Tenderness in the Anatomic Snuffbox: the hollow at the base of the thumb, which points to a scaphoid fracture and warrants specific attention.
- Numbness in the Fingers: which raises the question of nerve compression from swelling.
Wrist pain after a fall with tenderness at the base of the thumb should be treated as a scaphoid fracture until proven otherwise, even where the radiographs are normal, because a proportion of these are invisible on initial films and a missed scaphoid fracture frequently fails to heal.
Diagnosis
Radiographs establish most wrist fractures and the alignment they show is what treatment decisions rest on. CT is used for fractures extending into the joint surface, for scaphoid fractures where healing is in question, and for complex patterns. MRI identifies fractures invisible on radiographs, which is its main role in the scaphoid, and it also shows the associated ligament injuries that accompany a meaningful proportion of distal radius fractures.
Treatment Principles
- Stable, Non Displaced Fractures: treated in a cast or splint, with the position confirmed on repeat radiographs during healing.
- Displaced Fractures: reduced and either held in a cast or fixed surgically, depending on whether the reduction will hold.
- Fractures Involving the Joint Surface: generally fixed, since a step in the joint surface leads to arthritis.
- Fixation Options: plates and screws, pins, or external fixation depending on the pattern and the bone quality.
- Early Finger Motion: started immediately in every case, whether the fracture is treated in a cast or surgically, because stiff fingers are the most common lasting problem after a wrist fracture.
Recovery After a Wrist Fracture
- Weeks One to Six: immobilized, with finger, elbow, and shoulder motion maintained throughout.
- Weeks Six to Twelve: cast or splint discontinued as healing is confirmed, with wrist motion restored through hand therapy.
- Months Three to Six: grip strength rebuilding, which is the slowest element.
- Months Six to Twelve: the final result settling, with stiffness and swelling continuing to improve across the first year.
Schedule a Wrist Fracture Consultation in New York City
A wrist that still hurts several weeks after a fall, particularly with tenderness at the base of the thumb, deserves reassessment rather than more time, since some of these fractures do not appear on the first set of radiographs. Dr. Struhl treats wrist and hand injuries at his Manhattan and Westchester offices. Contact Shoulders & Knees to schedule an appointment.
