Brief Outline of Wrist and Forearm Fracture
Should an person fall on an outstretched wrist, a break or fracture of the wrist or bones of the forearm may result. Activities vulnerable to such injury include running, cycling, skateboarding, rollerblading and other activities in which an outstretched hand may be used to break a fall.
Anatomy and physiology
The wrist consists of a series of radio-carpal and intercarpal articulations. However, most wrist movement occurs at the radio-carpal joint, an ellipsoid joint. The distal surface of the radius and articular disc articulate with the proximal row of carpals: the scaphoid, lunate, and triquestral (triquetrum). Movements are in combination with the intercarpal joints. The intercarpal joints are a series of plane joints, which have articulations between the two carpal row (midcarpal joint), plus articulations between each bone of the proximal carpal row and of the distal carpal row. The distal radio-ulnar joint is immediately adjacent to the radio-carpal joint. A cartilaginous disc separates the distal ulna and radius from the lunate and triquetral bones. Wrist fractures are breaks in one or more of these bones. The two most common wrist fractures are Colles’ fracture, which occurs near the end of the radius, and scaphoid fracture, which involves the scaphoid or navicular, a small bone located on the thumb-side of the wrist that joins the radius.
Cause of Wrist Fracture
- A fall onto an outstretched wrist.
- A blow to the wrist.
- Extreme twisting of the wrist.
Signs and symptoms
Deformity of the wrist. Pain and swelling. Limited motion in the thumb or wrist.
Complications if left unattended
Wrist fractures often fuse naturally, though complications may arise in the untreated fracture leading to limitations of wrist movement and forearm rotation, pronation, and supination. Osteoarthritis may also arise following untreated fractures. Untreated or misdiagnosed scaphoid fractures run the risk of non-union or malunion of fractured bone segments.
- Plates and screws fixation
- Fibreglass cast
Rehabilitation and prevention
Immobilisation with a rigid cast is generally required for such fractures to properly heal, with x-ray follow-ups to analyse improvement. Where surgery is required, wires or screws may be employed to fuse fractured segments.