Fractures of the wrist
The wrist joint connects the regions of the forearm and hand involving the lower portion of the radius, the ulna and the carpal bones.
Distal radius fractures are the most common upper extremity fracture. In young people these fractures are usually sports. In the elderly, the lack of bone density (osteoporosis) makes this region very susceptible to fracture even with small impact.
The wrist fracture often requires reduction of bone fragments to the anatomic position. The immediate reduction performed in the ER needs followed-up care to make sure there is no further displacement. Older patients usually benefit from conservative treatment with immobilization for 8 weeks. In young patients the displacement is usually difficult to manage with cast immobilization and surgery is needed making a small operation for platin and screwing the fragments. The patient may return to normal activity as quickly as possible and with limited risk of complications.
The scaphoid bone is the most common fracture of the carpal bones after falls with an outstretched hand. This is a characteristic injury in sports such as motorcycling, cycling and skateboarding where they can suffer high speed injuries. The pain is located along the axis of the thumb and the tenderness in the wrist area (snuffbox) is extreme. Displaced fractures usually required surgically stabilization through the introduction of percutaneous intraosseous screws.
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