Wrist Fracture Treatment Options: Exploring Surgical and Non-Surgical Methods

The wrist comprises 10 bones in total - the two forearm long bones (radius and ulna) and the 8 small carpal bones, all of which are vulnerable to fracture. However, the term “wrist fracture” is usually meant to describe a fracture of the radius near the wrist joint proper - called a distal radius fracture. Fractures here commonly arise from incidents such as slips and falls as you fall on an outstretched hand. The force of the impact causes the wrist to break as it is a weak spot in your arm. Car accidents and snowboarding injuries are also common activities which can lead to fractures. A wrist fracture is also a type of “fragility fracture” in patients with osteoporosis - weak bone which usually occurs with aging. 

Without proper wrist fracture treatment, the injury may not heal correctly, leading to lifelong deformities and complications. Therefore, if you suspect that you have a fractured wrist, it's crucial to seek appropriate medical attention immediately.

What are fractured wrist symptoms?

If you have experienced a blow to the wrist, either from a hit or from landing on your hands, it's important to be cautious about any possible wrist fractures. 

If you are experiencing pain, swelling, excessive bruising, after a fall or a hit, coupled with limited range of motion and tenderness, it's highly likely that your wrist is fractured. 

In such a scenario, it's important to seek medical attention and have it x-rayed as this would give you a diagnosis. After that you can then have the wrist immobilized, typically with a splint or a brace. The faster you seek treatment, the lower the risk of deformity and other complications. This will help ensure a quicker and smoother recovery.

Is my wrist broken or sprained?

It's important to note that many hand and wrist conditions can often present with the same or similar symptoms, such as pain and swelling. 

In the short time after a hand or wrist injury, it can be difficult to determine the extent of the damage. Only a trained medical professional can accurately assess the injury and it may be necessary to have an X-ray.

Head to the emergency room as soon as possible or to an urgent care. It's crucial to avoid attempting self-diagnosis after experiencing a hand or wrist injury. While it may seem harmless, self-diagnosis can cause further harm.

How do you treat a wrist fracture?

There is no one-size-fits-all approach here. The truth of the situation is many variables my be considered. The bone fracture, the amount of displacement (separation), the age of the patient, the function of the patient, and the medical problems of the patient.

Your medical professional should decide how to treat a wrist fracture. They’ll examine your wrist, usually perform x-rays, and determine the extent of the injury. Subsequently, they may suggest either conservative or surgical treatment. Here are some options.

What are the options for wrist fracture treatment without surgery?

Naturally, immobilization is the first step with any fracture. Usually, this involves a splint or cast to stabilize the area and prevent any further movement. This helps mitigate pain and may also be used as your definitive treatment.

If you are lucky, some fractures are very small and without displacement. This is the hairline fracture. Usually a brace, splint, or a cast is all that is needed.

However, in some cases, it may be necessary for the doctor to perform a closed reduction. This is a manipulation of the fractured bone to improve the alignment to hopefully allow the bone to heal in an appropriate position. It can be excruciatingly painful and is usually performed under local or general anesthesia.

Finally, some fractures are so bad that surgery is the only logical choice. More often than not, surgery involves a cut to the wrist skin, mobilizing and reducing (alignement) the wrist bone, and then placing a small, thin plate and screws being placed on the radius which fixes the fragments correctly. This is an open reduction internal fixation procedure.

In the aftermath of conservative or operative treatment, you might have to undergo physical therapy. It’s not just because of the break but due to the period of immobility (due to it being in the cast) or need for surgery; you’ll have to work a bit harder to return to the state of full wrist mobility and strength

When does a broken wrist need surgery?

If your doctor notices displaced fractures, intra-articular fractures, or open fractures, they might suggest (or insist on) surgery. The same holds true with unstable fractures, multiple fractures, or complex injuries. 

Even though it is important that the bones regenerate; it is equally important for them to heal properly. Sometimes, to ensure that the growth is correct and meets the necessary standards, surgery may be required. 

How long does a wrist surgery take?

Depending on the type of procedure, surgery lasts anywhere between 30 minutes and 2 hours. Usually, the duration lasts approximately 45-60 minutes, unless it's a complex procedure.

How long does it take for a wrist fracture to heal?

Several factors impact the healing process of a wrist fracture; the nature of the injury, individuality, and the wrist fracture treatment method used:

• The severity of the injury: The more severe the injury is, the longer it will take to heal.

• The individual’s overall health: Some people indeed seem to recover from illnesses or injuries faster than others. A person who is generally healthy may have an advantage in terms of healing speed.

• Type of treatment received: It's important to remember that recovery from surgery can take some time, but it's not always due to the procedure itself. In many cases, surgery is necessary because the injury or condition being treated is complex or severe, so healing naturally takes longer.

• The age of the patient: not surprisingly, young people often heal quicker, and with fewer complications, than older adults.

While the bone may take 6-12 weeks to fully heal, the soft tissues may also take some time. Everyone is different and that is why you should follow your doctor’s instructions as they have been designed for you and your specific injury.

What happens if I don’t have surgery when it is recommended?

Potentially if you do not have surgery, you may have complications. It is possible that the bones do not heal; however, it is more likely that they will heal but with an incorrect alignment. This is termed a malunion. A malunion may lead to limited and painful motion in the wrist, deformity in the forearm (called a dinner fork deformity), arthritis, weakness to grip, and pain - with or without motion.

Wrap-up

It's easy to take our wrists for granted until we experience a fracture. This is why it's crucial to prioritize proper healing. If you suspect a wrist fracture, seek medical attention immediately. A medical professional will be able to diagnose the injury and provide guidance on the best course of wrist fracture treatment. Following their advice is essential for a successful recovery.

You can explore treatment options for a fractured wrist with the experts at the Orthopedic Institute of NJ.