If you've fractured your wrist, the team of orthopaedic specialists at Georgia Hand, Shoulder & Elbow in Atlanta and Marietta, Georgia, are here to help treat your injury. Their orthopaedic expertise can ensure a speedy recovery and full range of motion in your hand and arm following treatment. Schedule your appointment at one of their Atlanta or Marietta locations today to avoid additional pain or potential arthritis in your wrist.
A scaphoid fracture is unique because breaking this bone on the thumb-side of your wrist may cause pain without the typical swelling or loss of motion you’d expect from a fracture. Left untreated, a scaphoid fracture can lead to arthritis and increasing pain. It’s important to see the orthopaedic specialists at Georgia Hand Shoulder Elbow if you have any pain in your wrist(s). Schedule your appointment in their Atlanta or Marietta, Georgia office today.
The scaphoid, also referred to as the navicular, is one of the eight small bones of the wrist, known as carpal bones. This particular bone gets its name from its shape, which is like a ship. Located on the thumb-side (radial side) of the wrist, the scaphoid can be fractured after a fall onto the hand.
Pain along the radial aspect of the wrist just below the thumb is the most common presenting complaint of patients with acute (recent) scaphoid fractures. Movement of the wrist and thumb, as well as weight-bearing through the hand, may increase the pain. Occasionally, scaphoid fractures are not terribly painful and may go undetected for some time. In this case, they typically do not heal, developing into a nonunion. This problem can lead to arthritis of the wrist and radiocarpal joint. In this instance, pain may be more generalized around the wrist.
Point tenderness directly over the scaphoid in an area known as the "snuff box" is suggestive of a scaphoid fracture. X-ray examination of the wrist is performed with specific views to fully visualize the scaphoid. Some scaphoid fractures are nondisplaced and difficult to diagnose on routine x-rays. In this instance, a bone scan or MRI may be ordered. In the case of scaphoid nonunions or displaced fractures, a CT scan may be needed to assist with the planning of operative treatment.
Nondisplaced, acute scaphoid fractures may be successfully treated in a cast, however, they may take up to 16 weeks to heal. Another treatment option entails the placement of a screw into the scaphoid. With this treatment method, the time needed to be in a cast is limited to 2-4 weeks. After the cast is removed, a removable splint is worn until the fracture shows evidence of healing (6-8 weeks).
Displaced fractures have a high rate of not healing (nonunion), therefore, they require operative treatment. Usually, this is performed using a screw as mentioned above. Occasionally, there is a need for a bone graft, which may be taken from the distal radius or the pelvis.
Scaphoid nonunions require operative intervention, as arthritis is likely to develop if left untreated. Bone grafting is frequently needed to address this problem. Postoperative immobilization may also be longer than with an acute fracture.
When you fall onto an outstretched hand, you may fracture the distal radius, the arm bone on the side of your thumb near the wrist. The orthopaedic specialists at Georgia Hand Shoulder Elbow in Atlanta and Marietta, Georgia, are the team you need to treat your distal radius fracture. Their orthopaedic expertise can ensure optimal recovery and protect the full range of motions in your hand and arm.
The radius and ulna are the two bones of the forearm. The radius is the bone located on the thumb-side of the wrist, with the ulna being located on the small finger-side. Distal refers to the portion of the bone closest to the wrist while proximal refers to the portion closest to the elbow.
At the level of the wrist, the distal radius contributes to two different joints. The first joint, called the distal radioulnar joint, is between the ulna and the radius and is responsible for the rotation of the hand and forearm (supination and pronation). The second, called the radiocarpal joint but commonly referred to as the "wrist joint," is between the small bones of the wrist (carpus) and the radius.
Eighty percent of the force seen by the hand is transmitted through the radiocarpal joint. When someone falls onto an outstretched hand in an effort to brace their fall, the force of the fall can exceed the strength of the bone. This causes the distal radius to fracture. The fracture typically occurs just underneath the radiocarpal joint, but it can extend into the joint creating multiple fragments and an uneven joint surface.
Wrist pain after a fall is the most common patient complaint after a distal radius fracture. Often times, a significant deformity of the wrist is noted due to the displacement of the fracture fragments. In addition, swelling and bruising are common.
The diagnosis is made with x-rays. These will demonstrate the fracture pattern and assist in treatment decisions. Occasionally, in the case of severe fractures or those not clearly seen with x-rays, a CT scan will be necessary.
Initial treatment of a distal radius fracture is the reduction (setting) of the fracture and splinting. This is usually performed in the emergency room. X-rays performed after reduction are then evaluated to determine the need for further treatment.
The goal of treatment is to allow the distal radius fracture to heal in an acceptable position with a smooth, well-aligned joint surface. In some cases, particularly in those where the fracture is only minimally displaced, does not extend into the radiocarpal joint, and is stable after the initial reduction, the injury can be treated with casting alone.
If the fracture is in a bad position, unable to be held in a good position with a cast alone, or has significant involvement of the joint surface, operative treatment is indicated. There are several options available to your surgeon including plates, pins, and external fixation (pins and bars). The decision on which surgical option is most appropriate is best made through discussions between the patient and surgeon after careful consideration of the particular fracture characteristics.