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Wrist Fractures

The radius is located in the forearm. The forearm consists of two bones, the radius and the ulna. The radius is the larger bone. A distal radius fracture occurs when there is break at the end of the radius bone closer to the hand rather than the elbow. A distal radius fracture is the most common area to break a bone in the arm. This injury usually occurs with a fall on an outstretched hand. At times, the other bone in the forearm breaks. This would be called an ulna fracture.

Symptoms

When there is a break in the bone of the wrist, it usually causes immediate pain. There can be swelling and bruising. If the bone is angulated, the wrist will look bent or deformed.

Treatment

Your physician will take radiographs of the wrist to evaluate thefracture better. Breaks typically occur one inch from the end of the bone. If the fracture goes through the joint, it is called an “intra-articular” fracture. If fracture does not go through the joint it is called an “extra-articular” fracture. If the fracture goes through the skin, it is called an “open fracture.” If the break is not very painful, treatment can wait until the next day. Ice, elevation, and a splint may be used to help with the discomfort. If the fracture is very painful, if there is associated numbness or tingling of the hand or fingers, if the fingers are not pink and your child cannot move his/her fingers, immediate treatment is needed.

Non-Surgical Treatment
Most distal radius fractures can be treated non-surgically with some type of immobilization such as a cast. If the fracture is angulated, it may be need to be realigned to the proper position or “anatomical alignment”. This is called a “closed reduction”. Your child is typically immobilized in cast for 4–7 weeks depending on the severity of the break. Your child will need periodic follow up visits with your physician to evaluate how the cast is fitting and the alignment of the bones, which is evaluated by X-Rays.

Surgical Treatment
Most wrist fractures do not need surgical intervention. In the cases where the fracture is not able to be “reduced” or placed back into the proper alignment and it will affect the motion of the arm, surgery may be needed. In most cases, “closed reductions” are preformed with sedation or pain medicine. In some cases, the fracture will need an “open reduction” as well as hardware such as pins, plates, or screws used to help realign the bone.

What happens after the fracture heals?

In general, after the bone has healed, kids return to their normal activities without any consequences of the fracture. Most children do not require any physical therapy. Restriction of contact sports and physicalactivity is for 2 weeks to 1 month after the cast is removed depending on the severity of the fracture. Generally, your child may begin to progress activities as tolerated thereafter. Stiffness around the wrist joint after the cast is removed is common. Typically, children’s motion and strength is returned to normal 1–3 months after the cast is removed.