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What You Should Know About Hand and Wrist Fractures

News / January 31, 2021

Hand and wrist fractures are common injuries that could happen to anyone. Proper movement and joint health ensures you can perform daily activities such as gripping, typing, and lifting. However, whenever you have a crack or break, pain may limit your range of motion, making day-to-day life more difficult. 

The key to proper recovery comes from the expertise of your orthopedic hand and wrist specialist. At APEX Orthopedics & Sports Medicine, Dr. Deardorff’s practice focuses on diagnosis and treatment for hand, wrist, and sometimes elbow conditions. With her years of experience and training, she effectively treats fractures for patients of all ages. 

Read on to learn more about hand and wrist fractures, treatment options, and what to expect during the recovery process. 

What is a hand and wrist fracture?

A fracture is a break or crack within a bone. For the hand and wrist, fractures could happen in one or more of the wrist bones or fingers. As with other areas of the body, fracture-causing injuries may come from anything—sports, car accidents, jammed fingers, even yard work. However, people most commonly sustain a wrist and/or hand fracture when trying to catch themselves during a fall. 

If you think you have a broken bone, it’s vital that you visit a physician as soon as possible. Waiting for treatment (or avoiding treatment altogether) could lead to misaligned healing, and your doctor may have to rebreak the bone to fix the issue. 

How do I know whether I have a fracture?

Unless the break is severe, you may not know for sure you have a fracture without a medical exam and diagnostic studies, but you can watch for symptoms such as: 

  • Pain
  • Bruising 
  • Swelling
  • Inability to move joints
  • Tenderness
  • Obvious deformities

Types of hand and wrist fractures 

Not all hand and wrist fractures are the same nor do they show the same symptoms. While there are several types of hand and wrist fractures, a majority of fractures fall into two main categories:

  1. Distal Radius/Ulnar fractures
  2. Scaphoid fractures

Distal Radius/Ulnar fractures

Your forearm (below the elbow) is made up of two bones—the radius and the ulna—which connect to the wrist bones. The word “distal” signifies the end furthest from the center of the body. Therefore, a distal radius or ulnar fracture is a break at the end of the bone near the wrist. This type of fracture often occurs from a fall, making it the most common type of wrist fracture.

Symptoms include:

  • Pain
  • Wrist swelling
  • Wrist deformity
  • Inability to flex or rotate the wrist

Treatment options

Non-operative: If your fracture is stable enough, a cast will probably work to promote properly aligned bone healing. Dr. Deardorff typically keeps her patients in casts for 6 to 8 weeks, and during that process, she closely monitors healing via X-ray exams. After your cast is removed, Dr. Deardorff will outline activity restrictions you should follow for about 4 weeks.

Operative: If your fracture is in poor alignment and you opt for a surgical treatment, Dr. Deardorff will make at least one incision in the forearm/wrist area to realign the bone. After surgery, your sutures will remain for approximately 10 days, and you will wear a cast (or wrist brace) for around 6 weeks. 

To promote healing, Dr. Deardorff recommends you take Vitamin D and obtain enough calcium from your diet each day. In addition, you should avoid:

  • Smoking
  • Tobacco products

When you visit APEX for distal radius/ulnar fractures, we will supply resources and documents to guide you through the healing process. It is especially important to move your fingers and perform 6-pack exercises we provide. 

Learn more about wrist fracture recovery and other conditions. →

Scaphoid fractures

The scaphoid is a small oddly shaped bone that makes up part of the wrist (there are eight total bones). It sits at the bottom of the thumb closest to the radius bone of your forearm. 

Scaphoid fractures are commonly missed, so it’s very important to seek medical help if you have a wrist injury. If untreated, the fracture could not heal appropriately, leading to arthritis.

Similar to distal radius fractures, scaphoid fractures often happen from a fall, but the symptoms are more mild. Since scaphoid fractures typically only result in minimal swelling and some pain, many people mistake them for wrist sprains. 

Treatment options

Non-operative: The bone may take 8 to 16 weeks to fully heal inside a cast, and you will need a CT scan to ensure the bone is healing. 

Operative: If surgery is your best option, you will go through an outpatient procedure. Surgery typically involves placing a screw across the bone. After surgery, the fracture may still take 8 to 16 weeks to heal, though some people get into a brace quicker to regain mobility faster. You should avoid NSAIDs and nicotine to ensure healing goes smoothly as possible. Even after healing, you will probably require physical therapy.

The importance of wearing a cast for fracture recovery

A broken bone creates a gap at the fracture site. Bone healing cells have to jump across the gap to knit the bone together, but if the bone constantly moves, those cells can’t cross and heal the fracture. A cast (or even a splint in some cases) holds the bones  together so healing can continue properly. Without a cast or splint, bone healing cells will build bone everywhere due to too much motion. As a result, healing could take a lot longer. 

If you have concerns about itching or discomfort, speak to your physician. While your physician may not take off the cast, you can gain information on how to alleviate your symptoms for more comfort. 

The difference between child and adult hand and wrist fracture treatment 

The first big difference between treating a child and an adult are the growth plates in children, which presents a problem and an advantage. 

The problem: A growth plate injury could cause the plates to asymmetrically or even completely close down. In many cases, there is no concrete way to know whether or not the plates will close, so Dr. Deardorff makes sure these fractures heal in the best alignment possible. 

The advantage: Children’s bones remodel. This means that the bone does not have to heal in a perfect position since it will straighten with time. One side of bone will grow faster than the other to compensate. This greatly reduces the need for surgery.

With older adults, we can sometimes accept mild deformities depending on lifestyle factors. For example, one 70-year-old patient may live a fairly sedentary lifestyle while another may bike every day. At the end of the day, Dr. Deardorff treats the patient based on physiological age/activity rather than the actual age. 

What to expect during your initial appointment at APEX Orthopedics 

First, you should make sure you have filled out all of your paperwork and have your medical history prepared. If you have previous diagnostic tests, bring them so we can review and better understand your condition. 

During your appointment, you will sit with Dr. Deardorff to discuss your problems, pain levels, exacerbating factors that increase or decrease pain, previous treatments, and more. From there, she will perform a physical exam and other necessary diagnostic studies. With all of the necessary information, Dr. Deardorff explains your diagnosis and treatment options, including which treatments will alleviate which conditions. 

People often come in with multiple diagnoses, so Dr. Deardorff delineates each problem, giving patients a good understanding of their symptoms. For instance, if you come in for carpal tunnel surgery, she will highlight that it won’t resolve thumb arthritis pain. 

What to expect during follow-up appointments with Dr. Deardorff

Hand and wrist fractures often require more follow-up visits than other conditions, especially unstable fractures. Dr. Deardorff often takes X-rays every week for about three weeks until the bone starts to heal. That way, she can make sure the injury doesn’t displace or worsen. The last thing you would want is to find out six weeks later your wrist is crooked and needs further treatment. 

After the initial three weeks, Dr. Deardorff recommends follow-up appointments either three weeks later or after 10 days, depending on healing progress. At the end of the day, the number of follow-ups depends on the fracture’s stability. When you visit APEX for treatment, you will receive individualized care based on your unique needs, lifestyle, and goals. 

Get to know Dr. Deardorff at APEX Orthopedics & Sports Medicine

Dr. Valerie Deardorff is our only hand and wrist specialist at APEX, and she completed a Hand and Upper Extremity fellowship at the University of Miami. She specializes in chronic and acute conditions of the elbows, forearms, wrist, and hands. Her practice centers around her patients, and she believes being an educator is her most important role as a physician. 

With the help of the APEX’s private practice model, Dr. Deardorff ensures each patient receives the most value that doesn’t involve hidden fees or outlandish pricing. 

The core of her success lies in proper diagnosis. An appointment with Dr. Deardorff includes the highest quality technology to diagnose a patient’s underlying musculoskeletal conditions. From there, she can better understand which treatment will work best for you. 

For a thorough evaluation with Dr. Deardorff, call us at 913-642-0200 or schedule an appointment today.

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