![]() Sometimes the wrist fracture is out of significant alignment or in multiple pieces that prevent a cast from holding the position of the bones. Rarely, the fracture can move position, and a re-manipulation or an operation may be necessary. Ideally, you should be seen one to two weeks later with a repeat X-ray to check the position. This should be reinforced by wrapping tape or crepe bandage, so the cast feels snug again. Sandwich slabs are designed to allow for swelling, though they may become loose over the coming days. ![]() ![]() The arm may be 'sandwiched' between two plaster slabs or a full cast applied. This may be performed in the emergency department with a light anaesthetic or an operating theatre with a full anaesthetic. This cast remains on for at least six weeks.įractures that are slightly displaced and not in too many pieces may be treated with manipulation. This is exchanged at 1 to 2 weeks for a full cast. ![]() This will involve a cast - usually a half-cast (known as a back slab) initially to allow for swelling. If the fracture is undisplaced or the overall alignment is acceptable for your age and functional requirements, immobilisation may be appropriate. The goal of treatment is to place and maintain the bones in an appropriate position to heal in a 'functional' position. This is generally not helpful in managing acute wrist fractures.įor information on fracture healing and general management, see the link. For more complex fracture patterns, this will help plan for surgery. This may be useful in wrist fractures if the X-rays don't provide enough information - such as whether the fracture enters the wrist joint or to measure any steps in the joint surface. These will be used during follow-up to monitor the position of the wrist and ensure it remains in an appropriate position.Ī CT scan gives a three-dimensional picture of the bones. Information about fracture pattern and displacement can be sort from X-rays. These are the first line of tests and most often are all that is required. High energy injuries are seen in car accidents and falls from a bike. Osteoporosis (weak bones due to low density) may be the underlying cause. In patients over the age of 60, a fall from a standing position is the likely cause. There are two types of distal radius fractures You may see this described in your medical notes as "FOOSH". The most common cause for this fracture is falling onto an outstretched arm. These are less important when discussing acute wrist fractures. This may heal with scar tissue (rather than bone) and will look like a small piece of floating bone on an X-ray -this normal and expected.Ĭarpal ligaments - which there are many of. It may be reported as a "second fracture", but its role in the wrist is less important. Sometimes a small piece of bone is broken from the ulnar as the strong TFCC ligaments attach to it and are pulled away as the distal radius fractures. Triangular fibrocartilage complex (TFCC) - attached to the ulnar 'styloid'. Ulnar (long forearm bone - which starts as the tip of the elbow)Ĭarpal bones (scaphoid and lunate these are two of eight of the small bones of the hand) Dr Keran Sundaraj MBBS MSc (Trauma) FRACS FAOAĭistal radius (AKA wrist or Colles) fractures are the most common break in the upper limb.
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