Treatment of Fractures

When you break a bone, the most common treatment is to realign or restore the broken bone to its original position. Usually, this is done by manipulating the bones manually and an operation is not needed. However, once you break a bone, some distortion or displacement will invariably result. It is very difficult to realign broken bones exactly as they were before they were injured. However, the human body is wonderfully designed and very adaptable. We have some latitude when realigning and resetting a bone which, after healing, will enable the bone to adequately perform all of its normal functions. The realignment may not be perfect, but it is certainly adequate for us to resume our regularly-scheduled lives.

There is a great deal of reserve in the human wrist joint. Most people are able to flex and extend their wrist through an incredibly wide arc of 160 to 180 degrees. They can extend it 90 degrees, and they can flex or bend it down to 90 degrees; however, it is only necessary to have about 20 degrees active flexion and 20 degrees active extension, for a total arc of about 40 degrees. So even this limited amount of mobility still allows one to use his hand and wrist in most of its normal functions. Remember, as long as the wrist is pain-free, its function is not significantly impaired.

Radius and ulna fractures are the most common fractures. Treatment usually consists of using a cast to hold the position of the bones for 6-8 weeks.

Scaphoid Fractures

Scaphoid fractures present a special problem because they are difficult to diagnose initially, and the poor blood supply hampers healing. It may be necessary to place the injured wrist inside a cast for an extended period of time, up to 3 months, in order to allow the fracture to heal. If the wrist does not heal, then surgical treatment is necessary.

Carpal Tunnel Syndrome

The initial treatment of Carpal Tunnel Syndrome usually involves immobilizing the wrist and hand with a splint (see illustration at left), and modifying the pattern of activity. A splint can be very useful, especially at night. It allows the wrist to be maintained in a position of extension, and this helps relieve the pressure on the painful area.

Other potential non-surgical treatments for wrist pain include steroid injections. With Carpal Tunnel Syndrome, steroid injections into the carpal canal are not recommended, because of the potential for permanent nerve damage.

DeQuervain’s Disease

With DeQuervain’s Disease, the first approach to treatment is to modify the activity which is causing the problem, by changing the pattern in which the hand and wrist are used. In some cases, it may be necessary to restrict the activity that is causing the problem. The wrist can be rested by immobilizing it in a splint (see illustration at left), which allows the swelling and inflammation to subside. Medication can also be used to alleviate the swelling, reduce the inflammation, and relieve the pain.

DeQuervain’s Disease is frequently treated with the injection of steroid medication and local anesthesia such as Lidocaine. This treatment is often very effective, and in some cases has completely resolved the problem.

Treatments for Arthritis

Initially, over-the-counter medications such as aspirin, ibuprofen, and acetaminophen are used. If these medications prove to be unsuccessful, there are a number of anti-inflammatory, analgesic medicines that can be prescribed by a doctor.