If you think that because you are young and have strong bones you are safe from wrist injuries, you are very wrong. In fact, it is common in young adults who do intense activity, and also in people over 65 because of osteoporotic wear and tear. But you can treat it without fear with the keys offered by Plastic and Reconstructive Surgery dedicated to Hand Surgery.
Have I injured my wrist? Symptoms and diagnosis
Regardless of the severity of the injury, all patients present intense pain and almost a third suffer from tingling, caused by pressure on the nerve. Before becoming alarmed, it is necessary to wait for a medical X-ray. This will be the moment to know the extent of the damage and, therefore, the necessary treatment.
If there is a deformity in the wrist, it is most likely to be a displacement of the fracture, i.e. the fractured bones have moved out of position. When this occurs, in some cases there will also be damage to the ligaments, and perhaps also to the joints. For this reason, it is advisable to complement the study with a CT scan or MRI to obtain a better view of the fracture.
Splint or plaster cast, only for minor cases
In not very serious fractures, without displacement and stable, it is usual to place a splint or plaster cast. Previously, a closed reduction maneuver must be performed under local anesthesia. This is what is called conservative treatment, which will be followed by successive control X-rays during the first three or four weeks. From then on, the recovery of the usual mobility of the wrist is constant. Conservative treatment therefore works well in fractures with little or no displacement, and is also applied depending on the age of the patient. For example, it is usually satisfactory for low-activity elderly people.
When to resort to wrist surgery?
Wrist surgery with surgery is usually reserved for displaced, more severe, irreducible or unstable fractures. But it can also be chosen if the patient prefers. In cases where the patient is unwilling to undergo orthopedic treatment, he or she may choose to undergo surgery. It may also be an option for those patients who, because of their activity, need a quick recovery.
During surgery, an incision will be made in the palmar aspect of the wrist, under local anesthesia, and the fragments will be manipulated until they are perfectly reduced and then stabilized with a plate and screws. This procedure is the one with the best results in the medium and long term.
The anatomical reduction of the fragments is extremely important for the prognosis, especially in intra-articular fractures. In this case, fracture reduction is performed by arthroscopy because it allows the fracture line to be seen directly and the articular steps to be corrected. It also allows to see and treat ligamentous lesions, very important structures in the stability of the wrist.
In the case of occurrence, the most frequent is wrist stiffness. For that reason, during the rehabilitation it will be tried to obtain the greater range of free movement without pain.