The wrist joint is made up eight tiny bones known as the carpals and two larger forearm bones, the radius and ulna. The radius bone is located on the thumb side and the ulna bone is located on the little finger side of the forearm. The eight carpal bones (capitate, hamate, lunate, pisiform, scaphoid, trapezium, trapezoid and triquetrum) are arranged in two rows, one on top of the other. The scaphoid and lunate bones are connected to the radius (Fig 1-3). The shape and construction of the carpal bones, radius and ulna bones provides great flexibility at the wrist joint allowing twisting, bending, extending and side to side movements. A severe wrist injury such as a fracture (break) to the radius, ulna or carpal bones in the wrist joint is diagnosed as a wrist fracture. Wrist injuries commonly occur from falling on an outstretched hand, a sports-related accident or a forceful injury such as an auto accident.
The wrist is a complex network of bones and joints. When a fracture occurs in the wrist, the most common carpal bone injured is the scaphoid. The scaphoid bone is located on the thumb side. It is the size and shape of a cashew and is one of the largest carpal bones in the wrist. The scaphoid bone link s the upper carpal bones to the lower carpal bones and actually helps to stabilize the carpal bones. A scaphoid fracture is only one of the many types of wrist fractures that can occur. Trapezoid, radius, ulna and lunate are just a few of the bones that can also be affected by a wrist injury.
Wrist pain, swelling, decreased mobility of the hand and wrist and possible deformity of the wrist are all some of the typical fractured wrist symptons. Fingers, hand and arm stiffness are common symptoms of a wrist fracture, especially in an older individual. Fractures can be clean, simple breaks or they can be unstable with bone fragments that displace or shift, causing the wrist to appear crooked. In other wrist fracture cases, the bone(s) may shatter causing the bone or bone fragments to break through the skin. This type of wrist fracture is called an open (compound) fracture..
When a patient with wrist pain comes to Hand to Shoulder Center of Wisconsin, our fellowship trained orthopeadic surgeons evaluate past and present medical history. X-rays are taken and evaluated. Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) may be ordered if more detailed views of the fracture and fragments are needed to help determine the best treatment option. Surgical and non-surgical treatment options vary widely depending on the location and severity of the wrist injury, the pattern of the fracture or displacement, and the stability of the wrist. Non-surgical fracture treatment – In simple wrist fracture s when the fractured bone remains aligned, a splint or plaster cast can be applied (Fig. 4-5). In more severe fractures when the bone is slightly misaligned (displaced), the physician will provide a local or general anesthesia and gently position or “reduce” the fractured bone back into alignment. A plaster cast is then applied to allow protection and stability to the injured bone(s).