Orthopaedics

What Are The Types Of Wrist Fracture ?

Colle’s Fracture:

The fracture occurring at the distal radius bone, located in our wrist, is named as Colles’ fracture. This type of wrist fracture occurs at the far most part of the arm measured form the point of attachment. It occurs at a joint called the cortico-cancellous junction in the arm.

  • Occurrence:

    This occurs in the forearm near the wrist. It is a common type of fracture that may hap to any age group and any sex. But difference may be seen in the patterns. The fracture may be extraarticular in elderly people due to weaker cortex. Younger people tend to have more complex extraarticular fractures as they require more energy and stress for the fracture to be caused. In children the epiphyseal plate is weak, thus causing the epiphyseal slip. Women with menopausal osteoporosis are more prone to such fractures.

  • Causes:

    A forward fall onto a hard surface resulting in an extended outstretched hands to break the fall is the most common cause. Overuse of wrist may also cause such fracture.

  • Eponym:

    This type of wrist fracture is named according to an Irish surgeon, Abraham Colles (1773-1843).

  • Symptoms:

    Sudden and severe pain, swelling and bruising in the wrist and disfigurement of the wrist.

  • Diagnosis:

    X-rays of the wrist and the forearm was done to confirm.

  • Anatomy:

    This fracture is usually seen to occurs about an inch or two proximal to the radio-carpal joint. Thereby, causing displacement in the posterior and lateral side of the distal fragment. It can result in the formation of a dinner fork like deformity.

  • Treatment: T

    he approach to treatment and management is entirely dependent on the severity. A simple cast is enough to treat an undisplaced fracture. If mild angulation and displacement is found with the fracture, then a closed reduction may be ideally used. But in presence of significant angulation and deformity, an open reduction and internal or external fixation is mandatory. For temporary immobilization of forearm, wrist and hand fractures, the volar forearm splint is the best.

  • Duration Of Recovery:

    About 8 weeks.

Scaphoid Fracture:

This type of wrist fracture occurs at a small wrist bone called, Scaphoid.

  • Occurrence:

    This type of wrist fracture occurs most commonly in young and middle-aged adults (aged 15-60 years).

  • Cause:

    The most common cause is a fall on outstretched hands. Landing on outstretched hand cause injury to the scaphoid bone of the wrist.

  • Symptoms:

    Pain and swelling at the thumb base.

  • Anatomy:

    The scaphoid bone is situated at the radial side of the carpus. In simple terms it is located between the hand and the forearmĀ  in a posture where the thumbs points outwards. This bone is the largest bone when situated much away from the point of attachment. Its shape and size resembles a medium sized cashew.

  • Eponym: T

    his type of wrist fracture is very hard to get healed. So it is also named as navicular fracture.

  • Diagnosis:

    Most people complain of snuffbox tenderness. X-rays are done to confirm the fracture. Few people, where apparent detection of fracture is not possible, are casted for about 7-10 days on a feeling of tenderness on the scaphoid bone. And then a second set of X-ray is performed. Apparent healing will obviously occur in case iof hairline fractures. If still, the fracture is not apparent, then a CT Scan is recommended. Then the snuffbox area is observed carefully. AN MRI can be done for immediate diagnosis.

  • Treatment:

    The location of the fracture decides over the treatment. A cast may be enough in few cases, but other may demand more. The blood circulation to the Scaphoid is separate. It has its own flow of blood starting from the top of the bone. If this flow of blood is interrupted, then healing of the bone may not occur. And surgery may be necessary to mend the bone mechanically.

  • Duration Of Recovery:

    It can take around 6-12 weeks from of casting.

  • Complications:

    Avascular Necrosis (AVN). Non union may occur due to neglected, undiagnosed or untreated scaphoid fractures.

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