Dealing with Wrist Sprains and Fractures

From an interview with
Dr. Thomas DiStefano
McLeod Orthopaedics Cheraw

Wrist injuries can take the form of a sprain or a fracture. McLeod Orthopaedic Specialist Dr. Thomas DiStefano explains medical and surgical treatments.

Here’s an overview of Dr. DiStefano’s comments:
Wrist sprains are a very common injury. Most of them are very minor but some sprains can be severe. We grade wrist sprains in three types. You can either just strain the tendon, you can strain the tendon and partially tear the ligament or you can completely tear the ligament. The third type of injuries are more severe and often require medical or surgical treatment.

For ligaments, a lot of them can be repaired using absorbable anchors and suture tape or suture wires. Fractures often need to be fixed with more rigid support —  typically with either screws, plates, an external fixator or any combination of those. For simple wrist sprains we often put people in a splint for a couple weeks and then re-examine them two weeks later. If they resolve their pain, which most of them do, then we know that it was probably just a sprain.

Most broken bones take 8 weeks to heal. For treating them, it’ll typically take two casts, 4 weeks apart. At 8 weeks, the joint is very stiff and weak. Therapy becomes the critical part of  success. We usually get them into regular therapy for a month but have them do a home program for upwards to 3 months to regain their motion and strength.

Bones typically are easier to treat. Ligaments often will take a lot longer to heal. You’ll often hear people say it was better to break a bone than to sprain it. There is some truth to that, because the lingering effects of bad ligament sprains can take longer to heal than fractures.
 
We’ve become much more aggressive at doing surgical treatment of certain fractures, particularly distal radius and scaphoid fractures in the wrist. Distal radius fractures inherently disrupt the joint and cause arthritic damage to the joint just by the nature of the injury. By being able to more accurately put the fragments back together and to restore the anatomy, we’ve seen a great increase in the restoration of function and motion and a reduction in pain. Compared to 20 years ago, we much more aggressively fix these serious injuries.

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