Wrist Fracture

Wrist fractures are the most common fracture seen in orthopedics.  Despite that, there are many controversies regarding treatment. The most common treatment is still casting.  The wrist is re-aligned (reduced or set) and held first in a splint, then a cast until it is healed.  This typically takes an average of 6 weeks.  However, it is 2-4 MORE months until the motion and strength are enough to return to most activities.

Volar Locking Plate

Surgery is sometimes needed to realign the bone.  Some fractures are inherently unstable and the cast is not sufficient to maintain functional alignment.  New plates came out about 10 years ago that have changed the practice of treating these injuries.  The plates are strong and the screws lock not only to the bone, but also to the plate creating a metal-metal connection that is rigid.

Osteoporosis

Wrist fractures are associated with osteoporosis.  In the Journal of Hand Surgery (October 2004) women with wrist fractures were found to have osteoporosis 51% of the time and an additional 34% with osteopenia (total of 85% with weak bone).   A women over 50 years of age with a wrist fracture should have their bone density tested.

Vitamin C

Vitamin C turns out to be an important addition to wrist fracture treatment.  It has been shown effective to reduce the potential complication of CRPS (complex regional pain syndrome – also called RSD or SMP).  For more on that complicated topic see the link from wikipedia

Wrist Fracture – powerpoint slide show (NOT narrated)

Wrist Fractures – When to Operate – (narrated video)

Fractures of the distal radius, also called Colles’ Fractures are the most common fracture (broken bone) in orthopedics.  One would think that the decision on whether or not to operate would be well known. Here, in a 28 minute narrated slide show, and using literature both old and new, the factors are reviewed.  Hopefully, this can help on understanding the decision on when to operate and when to leave it in a cast.

This video is designed for orthopedic residents, experienced clinicians and curious patients…