For most wrist fractures, surgery is usually not required. However, it is necessary in some situations. For example, if the bones are shifted out of position, if the bones are fragmented and unstable, or if there is any joint involvement, surgery can be used successfully to treat the fracture.
If surgery is deemed to be necessary, there are a variety of options for treatment. Most fractures currently are treated with one small plate and several screws after the bones are placed in the correct position. Other fractures may be secured with pins to hold the bones in place.
Goal
- Proper alignment of the bone and ensure healing
Who qualifies?
- Fragmented, displaced or unstable fractures
- Joint involvement
Recovery
- Light activities can begin 1-2 months after cast removal or surgery
- Vigorous activities can begin 3-6 months after cast removal or surgery
- Average recovery takes about a year, although minor stiffness could be present up to 2 years.
- Physical therapy to restore range of motion and strength
Complications
- Bleeding
- Infection
- Ongoing stiffness
- Ongoing pain
- Development of osteoporosis later in life
Outcomes
- Most people are able to fully return to all previous activities
- Minor pain and stiffness may be present during the first 2 years.
Hand fracture surgery
Some of the more severe hand fractures require surgery to align and stabilize the bones. Pins, screws, wires, or plates can be implanted into the hand to hold the fracture in place.
The following conditions require surgical
intervention
- An open fracture
- Unstable or displaced fracture
- Loose bone fragments that could enter a joint
- Damage to the surrounding ligaments, nerves or blood
- Fractures that extend into a joint
Physical therapy to restore range of motion and strength
in the hand once the cast or splint is removed.
Goal
Proper realignment of hand bones.
Complications
- If the bones rotate during the healing process, then loss of function could result.
- Infection
- Ongoing stiffness or aching
- Osteoarthritis
- Nerve or blood vessel damage
- Lingering pain at implant site
Outcomes
The cast will remain for approximately three to four weeks, but gentle hand exercises may begin after about three weeks. Surgical outcomes: The temporary implants will be removed after sufficient bone healing has occurred. Due to the length of the immobilization period, there may be some initial joint stiffness in the hand.
