Wrist fractures are one of the commonest fractures to occur, and in patients with osteoporosis, they can frequently sustain a wrist fracture after a simple fall.
One of the signs of a fractured wrist after a fall is an angular deformity of the wrist, commonly known as a dinner fork deformity. The wrist will also be swollen and the patient will not be able to move the wrist due to pain.
Wrist fractures occur very close to the joint and involve the joint surface in many instances. This results in an articular, or joint fracture, which can significantly affect the mobility and flexibility of the joint after the fracture.
Xrays will show clearly the type of wrist fracture. A fracture that has significant angulation or deformity will need to be manipulated and reduced. In some cases, the fracture can be treated with casting for 6 weeks. However, if there is significant deformity or if the fracture has disrupted the joint surface, then surgery will be advisable to restore the alignment of the joint and to maximize the recovery potential.
The function of the wrist is important for many activities of daily living. A badly deformed, or mal-united, fracture of the wrist will result not just in a reduction in the ability to bend and extend the wrist, but also affect the rotation of the entire forearm. Hence it is important to ensure that the wrist fracture heals in a good position.
Surgery is frequently required in the treatment of a wrist fracture. It usually involves using metal plates and screws to hold and stabilize the fracture. The implants are usually made of titanium and there is no need to remove the implants in future after the fracture has healed. The surgery will typically take 1 to 2 hours and is usually performed under a general anaesthesia.
Immediately after surgery, the patient will start on a mobilization therapy programme so that they can quickly regain function and strength of the injured wrist. Patients who have had a previous wrist fracture are also at a much higher risk of having a subsequent osteoporotic fracture. Hence they should be investigated for osteoporosis and treatment should be started as soon as possible.