The wrist fracture is the rupture of at least one bone of the forearm in the part closest to the hand (distal).
The wrist is formed by the terminal part of the bones of the forearm: radius and ulna, in addition there are 8 small bones that connect the forearm with the hand: scaphoid, lunate, pyramidal, pisiform, trapezoid, trapezoid, capitate and hamato.
The 4 proximal bones (closest to the forearm) articulate with the radius and ulna, the other 4 form the joint with the bones of the hand, from the first to the fifth metacarpal.
Type of fracture:
- Colles’ fracture may involve a bone in the forearm, or both.
This type of injury causes the bone fragment to move towards the palm of the hand.
- Smith’s fracture is the opposite of that of Colles, in fact the fragment of bone that is part of the wrist joint moves toward the palm.
The classic mode where the fist breaks is the fall with the hands in front to protect the head, the hand makes a violent extension.
If the fracture occurs in the right hand and the patient is right handed, this rupture is more severe and causes great deficiency in relation to the left hand injury.
A fragment of bone can damage the nerves that pass through the wrist: radial, ulnar, and medial, can cause injury to the arteries and veins of the hand.
Who are the people affected?
It is a very common fracture, especially in older women in menopause .
It is rare in young people and in children, it occurs during a sports injury: skiing, cycling, motocross, soccer, etc.
Children may also have a green bough fracture, that is, it breaks only part of the bone, but the outer (periosteum) membrane remains intact.
The osteoporosis is a disease that affects almost all menopausal women and is characterized by a lower density calcium in the bones that are weaker.
What Are The Symptoms Of Fist Fracture?
In the acute phase, the symptoms are swelling and strong pain , the fist causes very intense pains.
Often, a simple concussion is mistaken for a fracture because the patient “jumps” even with a small passive movement of the hand.
In the acute post-phase, the symptoms are unbearable pain during movement, pressure and tightening of objects by hand.
If blood vessels, nerves or ligaments are also present, there may be more serious symptoms such as bleeding or paresis .
More stable fractures require fewer x-rays of control, usually done when gypsum is removed.
If the fracture can not be reduced to an acceptable level or if it is severely unstable and is at risk of being deviated, it is also immobilized with plaster, the physician may recommend surgery to reduce and stabilize fracture fragments.
This surgery is performed under local anesthesia .
Diagnosis of wrist fracture
The diagnosis is clinical, but it requires confirmation of the radiograph because if the patient has severe pain and inability to move the hand it is necessary to exclude the hematoma. The radiography may not show the bone lesion the day of the trauma, it is better to wait two days.
What to do? What is the treatment for wrist fracture?
If the joint is unstable and the fracture is undamaged, the orthopedic surgeon may recommend surgery to allow healing and speed recovery.
With an incomplete or no-deviation but not severe fracture, it is necessary to place the cast or an orthosis that immobilizes the hand and the wrist for a month, rarely the orthopedist recommends 2 months of joint blockage.
In the first month after injury, the patient should have a radiograph of the control every two weeks.
When the orthopedist believes that the formation of bone callus is sufficient can remove the plaster or the bracing.
Although doctors do not recommend it, for the first 30 days it is essential to perform magnetic therapy that decreases up to 50% consolidation time and reduces pain.
To relieve pain, you can also use other instrumental therapies such as laser treatmentor TECR ® ( capacitive and resistive energy transfer ).
The swelling remains for several months after the injury, can be reduced with contrast baths at home by placing the wrist in a bowl of cold water and then in warm water.
It is important that between the 2 basins there is about 10 ° of difference.
Rehabilitation exercise and physiotherapy for wrist fracture
When the radiograph shows the calcification of the fracture, you should start physical therapy ; in particular for wrist, elbow and hand because the movements are very fine and precise.
When elderly gentlemen remove the cast, they feel a lot of pain for at least the first week, especially if they have not done magnetic therapy for at least 1 hour a day.
The muscles of the forearm and hand become weak, so we must strengthen with isometric exercises (contraction in the absence of movement) and then lift weights or objects.
The recovery of the movement is achieved through exercises involving the fingers of the hand, wrist and forearm, in particular we must insist on:
- The clamp between the thumb and other fingers (opposition of the thumb)
- Pronation of the forearm (pouring water from the bottle)
- Supination of the elbow (by turning the door knob).
What is the recovery time to get back to work or have fun?
The time for scarring of a fracture without deviation from the wrist is short, usually within two months the patient returns to his daily activities with a little pain.
If the affected wrist fracture (and possibly cominutiva), if the affected person is an elderly person with osteoporosis, the prognosis exceeds 3 months, it can reach 6 months without treatment.
In young people, sometimes the time is shorter, but they serve at least 3 months to get back to work or sport.
The possible consequences and sequels of the fracture of the wrist are:
- Incorrect consolidation (without adequate alignment) that in case of exposed fracture causes functional limitation
- Post-traumatic osteoporosis of wrist and hand bones or Sudeck disease;