Wrist Fracture (Radius and Ulna)

$wrist fracture$

From Economou SG, Economou TS: Instructions for Surgery Patients.
Philadelphia, WB Saunders, 1998, p. 165.

Description
Radius and ulna wrist fracture is a broken bone (fracture) at the wrist involving one or both bones of the forearm, the ulna (the knobby bone on the side of the little finger) or the radius (the larger bone on the thumb side). This may be a complete or incomplete break. The break may involve the joint between the radius and ulna or involve the joint between the radius or ulna and the carpal bones of the hand.

Common Signs and Symptoms

Severe wrist pain at the time of injury
Tenderness, swelling, and later bruising of the wrist
Visible deformity if the fracture is complete and bone fragments separate (displaced) enough to distort normal body contours
Numbness, coldness or paralysis in the wrist or hand from pressure on the blood vessels or nerves

Treatment Considerations
If the bones are in appropriate alignment (position), the initial treatment consists of ice and elevation of the injured wrist at or above heart level to reduce swelling. Immobilization by splinting, casting, or bracing for 6 or more weeks is recommended to protect the bones while they heal. A sling may afford comfort while in the cast or splint. Severe fractures, fractures that are displaced (not in appropriate alignment), or fractures that do not provide a smooth wrist joint may require surgery to restore and maintain the joint in its normal position. Surgery usually includes repositioning the bones and holding the position with external fixation frame, plates, screws, or pins. After immobilization (with or without surgery), stretching and strengthening of the injured and weakened joint and surrounding muscles (due to the injury and the immobilization) are necessary. These are usually done with the assistance of a physical therapist or athletic trainer.

RICE Principle
With all acute injuries, follow the RICE principle to reduce swelling, pain and inflammation.

Rest- Do not use that hand as much if possible.
Ice- Use an ice pack for 20 minutes every two to three hours during the first 72 hours.
Compression- Use an ace wrap if needed. Start at the base of the fingers and wrap up to the elbow.
Elevation- Keep the injured arm above the level of the heart when you are sitting or lying down