A wrist fracture is a fracture of the forearm in the area near the hand (distal).
The wrist is formed by the end pieces of the forearm bones: ulna and spoke. There are also 8 small bones that connect the forearm with the hand: scaphoid, moon leg, triangle leg, pea leg, large polygonal leg, small polygonal leg, head leg and hook leg.
The 4 proximal bones (closest to the forearm) form a joint with ulna and spoke, the other 4 form a joint with the hand bones, from the first to the fifth metacarpal bones.
Type of break:
- A wrist or Colles fracture can involve one or both forearm bones.
This type of injury causes the bone fragment to move toward the back of the hand.
- A Smith fracture is the opposite of a Colles fracture. It moves yourself Bone fragment of the wrist towards the palm.
The classic way to break your wrist is to fall with your arms extended to protect your head. The hand is forcibly bent backwards.
If the fracture affects the right hand of a right-handed person, the fracture is more serious and causes a greater disability than an injury to the left hand.
A bone fragment can damage the nerves that run through the wrist: radial nerve, median nerve, and ulnar nerve. The arteries and veins of the hand can also be injured.
Who are the people affected??
It is a fracture that is very common, especially for older women in menopause.
In young people and Children it is rather rare and usually occurs as a result of a sports accident: skiing, cycling, motocross, football, etc.
© Massimo Defilippo
Children can also suffer a greenwood fracture, meaning that only part of the bone breaks, leaving the external membrane (periosteum) intact.
osteoporosis is a disease that almost all Affects menopausal women and is characterized by a lower calcium density in the bones, which makes them more prone to fractures.
What are the symptoms of a wrist fracture?
In the acute stage, symptoms such as swelling and severe pain appear, the wrist stings very strongly.
A simple bruise is often mistaken for a fracture, since the patient “jumps up” with a small passive hand movement.
In the post-acute stage, the symptoms are excruciating pain when moving, pressing and squeezing objects with the fist.
If blood vessels, nerves, or ligaments have also been injured, more serious symptoms may appear, such as hemorrhage or paralysis.
How to get a diagnosis?
The diagnosis is made clinically, but requires confirmation by a X-ray photograph, because if the patient feels severe pain and cannot move the hand, a bruise must be excluded. An x-ray could therefore show that the bone is not injured.
What to do? How is treated?
If the joint is unstable and the fracture is displaced, the orthopedic surgeon can get one surgical intervention recommend to allow healing and accelerate recovery.
If the fracture is incomplete or only slightly shifted, a Plaster cast or a orthosis that keep the hand and wrist immobile for over a month. The orthopedist rarely recommends immobilizing the joint for more than 2 months.
In the first month after the accident, the patient has to have an X-ray check every two weeks.
If the orthopedist believes that the callus formation on the bone is sufficient, he can remove the plaster cast or the orthosis.
Three-dimensional CT of the broken wrist, medial view
© Massimo Defilippo
A plaster cast must also be worn after a surgical procedure.
Even if the doctors do not explicitly recommend it, it is important to carry out magnetic therapy for the first 30 days, which shortens the duration of consolidation by up to 50% and significantly reduces the pain.
Other instrumental therapies, such as that, can be used to relieve pain laser- or Tecar therapy® .
The swelling persists for several weeks after the accident and can be reduced by using ups and downs can also be reduced at home by immersing the wrist in cold and then in warm water.
It is important that there is a temperature difference of about 10 °.
Exercises for rehabilitation and physiotherapy
If the x-ray shows calcification of the fracture, you should use the Physiokinesitherapy kick off; this is particularly important for the wrist and hand as the movements are very fine and precise.
When the plaster cast is removed from older women, they often feel severe pain for the first week, especially if magnetic therapy has not been carried out for at least 1 hour a day.
The muscles of the forearm and hand weaken and must therefore be strengthened first with isometric exercises (tensing without movement) and then by lifting objects or weights.
The restoration of mobility is achieved through exercises that involve the fingers, the wrist and the forearm. In particular, the focus is on:
How long does it take to recover before you can go back to work or play??
Fracture of ulna and spoke, X-ray with plaster cast
© Massimo Defilippo
The recovery time for a simple fracture is short and usually the patient can return to his normal everyday activities after two months without severe pain.
If the fracture of the wrist is displaced (and possibly a multiple fracture), this exceeds forecast in the elderly with osteoporosis 3 months and can take up to 6 months without treatment.
Young people have a much shorter time, but it takes at least 3 months to get back to work or sport.
Possible consequences and after-effects of a wrist fracture:
- Poor growth (not correctly aligned), which can cause functional restrictions if the break is moved.
- Post-traumatic osteoporosis of the wrist and hand, in the form of Sudeck’s disease.
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