As we get older, our bones are less able to withstand seemingly innocuous trips and falls, and the wrist bone or ‘distal radius’ is no exception. We rely on not only the shape of this bone but also its relative length and relationship to its neighbouring partner the ‘ulna’ to perform simple activities.
In a fall, the distal radius can be crushed, and whilst plaster casting will allow the injury to heal, it may not be in the most mechanically advantageous position.
New metalwork technology allows us to attempt to restore and hold normal anatomy, giving the bone a better chance of healing, as close to the original anatomy as bone quality will allow. In a day case operation, usually under a general anaesthetic, the bony alignment is corrected and held with a titanium plate and fixed angled screws. This construct is usually sound enough to obviate the need for additional plaster casting though occasionally this may be used if the bone is particularly soft.
Complex regional pain syndrome is a condition that has been reported to complicate 10% of all wrist fractures. It can leave patients with a stiff, painful, swollen hand and even with vigorous treatment make take many months to improve. We have found that by getting wrist fracture patients moving early, following stabilisation surgery, and supporting the healing process with Vitamin C and hand therapy, we are seeing far fewer complications of this injury.