What is it about ?
The wrist is a joint formed between the 2 bones of the forearm and the small bones located at the base of the hand. The bones of the forearm are the ulna or ulna (on the side of the little finger) and the radius (on the side of the thumb). The 8 small bones of the wrist form what is called the carpus.
Wrist fractures are the various lesions of the bones in this joint. The most common concern the radius (Goyrand-Smith fracture, Pouteau-Colles fracture, Barton fracture, Chauffeur fracture) and a carpal bone located on the side of the thumb, the scaphoid. Each of these fractures is treated in a specific way.
Sometimes complications also arise, such as compression of a nerve, problems with restoring mobility, poor consolidation of the bones. If severe pain, such as burning, occurs along with swelling of the wrist, it may be complex regional pain syndrome (CRPS) more commonly called algoneurodystrophy or algodystrophy.
How is the diagnosis made?
First of all, it is important to know under what circumstances the wrist injury occurred. It is sometimes due to a typical fall. For example: a scaphoid fracture usually occurs after a fall on the outstretched hand.
The doctor will carefully examine your wrist and pay special attention to pain, swelling, “bruising” (bruising or bruising), position (abnormal) and signs of nerve damage or damage to a vessel. important blood.
The x-ray can accurately determine where the fracture is. For a good evaluation, it is often necessary to take different shots.
In some cases, the doctor will order an additional examination, such as an MRI or a CT arthrography, in order to detect damage to the ligaments.
If there is a strong suspicion of a scaphoid fracture, the doctor will repeat the examination after one or two weeks or ask that you have a CT scan. The fracture may not be visible on the first x-ray.
What can you do ?
In the event of a fracture, you should immediately raise your arm. This helps to reduce the swelling of the wrist and thus prevent a possible cast from compressing your wrist too much.
It is very important to practice the exercises recommended by your physiotherapist several times a day. A cast helps immobilize the wrist joint, but it is often necessary to properly mobilize or move the shoulder, elbow, and finger joints to facilitate recovery after the cast has been removed.
Regularly performed correctly and maintaining the height of the cast arm can help prevent Complex Regional Pain Syndrome (CRPS).
How to recognize complications?
If the plaster is too tight, you have to remove it and put on a new one that squeezes less. Pain, tingling, or numbness in the fingers may indicate the compression of a nerve. The doctor will have to do a check-up; perhaps a new plaster should be placed.
If you are having difficulty moving your fingers, if there is a change in the temperature and color of the skin on the affected side, this may indicate the development of CRPS.
Persistent pain or limited mobility may indicate poor bone healing. A good follow-up by the doctor is certainly necessary.
What can the doctor do?
If one or more bone fragments are moved, we start by putting them back in their place. This is obviously done under anesthesia, possibly during a surgical operation. After that, a plaster is often laid. It is always done very carefully. The cast should be kept generally 4 to 6 weeks, and between 6 and 12 weeks for scaphoid fractures.
Follow-up should be scheduled to determine if healing is progressing normally. In the elderly or in the case of complex fractures, a follow-up X-ray is always taken before the joint becomes fully mobile again. The doctor may refer you to a physiotherapist to restore the mobility of the wrist joint as much as possible and to regain good muscle strength.
If the healing process does not go as desired, you will be referred to an orthopedist (surgeon specializing in orthopedics).
Want to know more?
- Radiography, here, Where to find on this page of Cliniques St Luc UCL
- Arthrography (arthrography) – Hôpital Erasme ULB
- MRI – Erasme ULB Hospital
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