Physiotherapy For A Broken Wrist
The wrist joint contains a total of 10 bones, is surrounded by a network of blood vessels and nerves, and through a range of tendons and muscles, it is the connecting point between the arm and the hand. These bones, muscles, tendons, nerves and blood vessels all work together in providing a very wide and complicated range of movement to the wrist, hand and fingers. For this reason, when you injure or break your wrist, it may not only affect the joint itself, but also your fingers, grip strength, tendons in your arm, etc. As a result, there is a high possibility that you will need physiotherapy to ensure that you regain your full range of movement and the use of your wrist.
Physiotherapy is usually administered by a qualified physiotherapist. They can help guide you through exercises that could help to restore any lost strength and mobility from the injury or healing process. Physiotherapists can also help educate you on further exercises you might be able to do at home, as well as check that your injury is healing correctly. To see if you might qualify to receive free physiotherapy while you recover, contact us today.
Complications Related To Treatment
Treatment of a broken wrist might include the use of a brace, splint or cast. Surgery and the insertion of metal plates or devices called external fixators might also be necessary. If surgery or external fixators are used, infection is a possible complication. Surgery, external fixators, splints, casts and braces can cause damage to nerves or blood vessels. The wrist area can experience pain, numbness or tingling after your wrist is healed. In some cases, nerve damage can be permanent.
How Long Does It Take To Recover From A Fractured Wrist
They seem to happen out of nowhere. A slip and fall accident. Car or motorcycle crashes. Sport and exercise injuries. Wrist fractures technically defined as a Colles fracture, or a distal radius fracture can seemingly happen at anytime, and they are very difficult to predict as a result.
Fractured wrists are also more common with people who have osteoporosis or thinning of the bones, since the weaker the bone, the easier it is to break.
It is estimated that 250,000 people in the United States end up fracturing the distal portion of their radius bone each year. In fact, one out every 10 broken bones in the U.S. results in a fractured wrist.
Broken Wrist Pain Management
There are many things you can do to help prevent your broken wrist pain getting worse. Some of these measures can be taken along with medication prescribed by your doctor, but it is important that you follow your doctors advice on taking medication and managing pain.
Using a broken wrist splint or brace is not only good for preventing further injury but they can also help in reducing pain, as the joint cannot freely move while it is still healing. Similarly, splints or supports such as a sling can help elevate the joint and can aid in reducing swelling. Another aid for swelling includes cold compresses applied to the area to help reduce the swelling and pain it causes.
In the later stages of recovery, completing light or gentle exercises could also help reduce stiffness, promote efficient blood flow in the area and aid the overall healing process.
Post Traumatic Wrist Arthritis
The wrist is a complicated joint involving eight carpal bones , and the two forearm bones .
Arthritis is a condition in which the cartilage on the ends of bones breaks down, causing pain, swelling, and stiffness in a joint. Arthritis in the wrist follows three general patterns. First, it may occur after a lifetime of normal every-day use of the hand. Second, inflammatory diseases such as rheumatoid arthritis or lupus can cause wrist arthritis.
The third common form of wrist arthritis is called Post Traumatic Arthritis. Generally, this type of arthritis may develop in the months to years following a fracture or other severe injury in the wrist. The patient does not remember the injury event if it occurred years earlier. Improper healing of wrist bone fractures can cause parts of the affected bone to become poorly aligned or even die, which negatively affects the cartilage. This pattern occurs when a Scaphoid fracture does not heal properly, in which case it is called Scaphoid Non-union Advanced Collapse wrist arthritis. Wrist injuries can also result in ligament tears. If a ligament is torn, it may allow a wrist bone to shift out of place, resulting in improper wear and tear of the cartilage. A ligament between the Scaphoid and the Lunate is at risk in a wrist injury. If it tears and causes arthritis, it is called Scapho-Lunate Advanced Collapse wrist arthritis.
The Most Crucial Stage Is The First Stage
We often believe that the very first day of an injury is the hardest to survive, and there is no doubt about it. Generally, breaking a bone is a severe case of having an injury, and to think that you have to sleep with a broken arm or leg tonight is genuinely terrifying, especially with the sharp burning pain bumping continuously along your skin, making it hard to stay comfortable. One will always feel scared and confused during that time, especially when there is a lot of pain.
Fractures first stage of also called the broken bone healing burning sensation, is meant to be challenging to bear as these pains follow your movements for at least 48 hours of the beginning of an injury. This phase inevitably gets on the nerves of the patient as bearing this pain needs a lot of patience and strength. The burning sensation of pain is due to the change of cell production and bleeding inside the muscle, which is a sign of early recovery. One should stay determined and hopeful at least for the first two days, and the strength will get back soon.
Stages Of Bone Fracture Recovery Healing
The whole fracture bone healing process takes place in three important stages, and by withstanding these stages., one should have a clear understanding of its sequence while looking forward to a recovery phase. The steps are as follows:
- also known as the burning sensation that occurs right after the fracture happens. The immediate trauma to the bone releases a sharp and unbearable pain, which generally happens when cells around the bone destroy themselves and pass out blood flow to start the recovery session on fracture. This process ends up causing burning pain and swelling to the area that usually lasts until 48 hours.
- Repairing phase is the second phase that begins after a few days of treatment or surgery. The bone starts to readjust and align into its regular shape slowly, and the fractured part feels numb. During this phase, the dressing stays stable and intact.
- The remodeling phase is the third and last stage of fracture recovery. The bone reforms and conjoins together, along with newly formed bone areas that took the hit genuinely. Bones may get healed in a few weeks, but it still needs to remodel itself, which can take up to months or a whole year. Bones are hard and stiff in structure, so it is natural for them to take that long to heal.
How Is A Scaphoid Fracture Diagnosed
Scaphoid fractures often arent always obvious and can be hard to diagnose.
The most common symptom is pain and tenderness over the anatomic snuffbox. The pain is often mild. It may get worse with pinching and gripping.
Theres frequently no noticeable deformity or swelling, so it doesnt look fractured. The pain may even improve in the days and weeks after the fracture. For these reasons, many people think its just a sprained wrist and delay getting appropriate treatment.
When not treated with immobilization right away, the fracture may fail to heal. This is called nonunion, and it can cause serious long-term complications. About of scaphoid fractures are nonunion. Avascular necrosis can also cause nonunion.
X-rays are the primary diagnostic tool. However, up to 25 percent of scaphoid fractures arent seen on an X-ray right after the injury.
If a fracture isnt seen, but your doctor still suspects you have one, your wrist will be immobilized with a thumb splint until repeat X-rays are taken 10 to 14 days later. By that time, a fracture has begun to heal and is more noticeable.
If your doctor sees a fracture but cant tell if the bones are aligned correctly or needs further information, a CT scan or MRI can help your doctor determine the proper treatment. A bone scan can also be used but its not as widely available as the other tests.
Chronic Pain After The Healing Is Complete
When you suffer a fracture, it will eventually heal and recover to the point that you no longer experience pain. Unfortunately, this does not happen for everyone. Some people may continue to experience pain long after the fracture and soft tissues have finished healing. This is what we call chronic pain.1
Chronic pain may be caused by nerve damage, the development of scar tissue, aggravation of underlying arthritis, or other causes. Luckily, this type of pain often can be treated. The type of treatment depends on the initial injury and the cause of your chronic pain.1
The most commonly used treatments for chronic pain are:1
- Physical therapy
Managing Pain During Recovery
During recovery, these pain management techniques can be used for patients:
- Physicians may prescribe a short course of opioid pain medications after a reduction. The prescription period will usually be brief, since opioids can cause troubling side effects and addiction.
- Patients can use non-steroid anti-inflammatory drugs such as ibuprofen or naproxen to manage pain and inflammation. NSAIDs may cause mild side effects and should be taken as directed.
- Ice therapy is a simple, low-risk way to manage pain and inflammation. Icing sessions can be done for 5 to 10 minutes every hour. Patients should avoid placing ice directly onto the skin, which can cause damage.
What Is A Broken Wrist
A wrist is classed as broken when one or more of the bones in the joint have been fractured and no longer hold together. Knowing the difference between a broken wrist and a fractured wrist can be difficult, so it is always safe to assume it is broken until a medical professional tells you otherwise. Common broken wrist signs can include:
- dull to severe pain in or around your wrist and hand
- swelling, and bruising in the area around the wrist
- a fractured wrist bone may protrude through the skin.
- the wrist may be bent at an odd angle
- you find it difficult to move or control your wrist or hand
Typical causes of broken wrists are usually through a heavy impact on the palm, wrist or arm that fractures or shatters the bones in the wrist. These can include trying to catch yourself in a fall, if you have been involved in a car accident where the wrist impacts the steering wheel, or even when playing a contact sport such as rugby or in line skating.
Wrist fractures can be divided up into different classifications depending on which bones have been fractured, and in what way, for example:
- Simple: with a clean break to one of the bones the make up the wrist
- Compound: where a fractured wrist bone punctures or damages the skin
- Greenstick: This classification is for broken wrists associated with children
- Comminuted: where the bone shatters into several pieces, usually caused by a heavy impact to the wrist bones, like that of a car accident.
Symptoms: What Does A Wrist Fracture Feel Like
- Wrist fractures usually result in immediate pain, swelling, and bruising.
- The wrist may or may not look crooked or bent backwards depending on the severity of the injury.
- Weakness or inability to bear weight on the wrist or a sensation of the wrist giving way or buckling can result from a fracture.
- A common misperception is that if you can move the wrist, it must not be broken. Often with less severe fractures the wrist can still be moved just with some discomfort.
- Occasionally if the swelling or deformity is severe enough, there can be numbness or tingling in the fingers.
Treatment For A Broken Arm Or Wrist
When you get to hospital the affected arm will be placed in a splint to support it and stop any broken bones from moving out of position.
You will also be given painkilling medicines for the pain.
An X-ray is then used to see if there is a break and how bad that break is.
A plaster cast can be used to keep your arm in place until it heals sometimes this may be done a few days later, to allow any swelling to go down first. You may be given a sling to support your arm.
A doctor may try to fit the broken bones back into place with their hands before applying a splint or cast you will be given medicine before this happens so you will not feel any pain. If you had a very bad break surgery may be carried out to fix broken bones back into place.
Before leaving hospital, you’ll be given painkillers to take home and advice on how to look after your cast.
You’ll be asked to attend follow-up appointments to check how your arm or wrist is healing.
What Are The Effects After A Broken Wrist
A broken wrist is a medical condition that occurs when at least one of the bones within the wrist sustains severe damage or injury, causing the bone to fracture. Common causes of a broken wrist include sport or motor vehicle injuries or bone disease, such as osteoporosis, according to MayoClinic.com. People who experience any of the effects after a broken wrist should seek prompt medical care for further evaluation and treatment.
The Stages Of Pain During The Healing Process Of A Fracture
In general, there are three stages of pain following a bone fracture. These are referred to as acute pain, subacute pain and chronic pain. Acute pain usually occurs immediately after you suffer the injury. After about a week or two, the worst pain is usually over. What happens next is that the fractured bone and the surrounding soft tissue begin to heal. This takes a couple of weeks and the pain you might experience during this stage is called subacute pain. The last stage of pain is chronic pain. This type of pain continues long after the fracture and soft tissues may have healed.1
All fractures cause either all or some of these types of pain. Although most people will experience all three types of pain, not everyone has to deal with chronic pain. On the other hand, some people may only experience acute pain. But regardless of the type of pain you’re experiencing, it’s good to know more about them. So, lets dive in.
How Long Does It Take To Recover From A Broken Arm Or Wrist
In most cases it takes around 6 to 8 weeks to recover from a broken arm or wrist. It can take longer if your arm or wrist was severely damaged.
You will need to wear your plaster cast until the broken bone heals. The skin under the cast may be itchy for a few days but this should pass.
The hospital will give you an advice sheet on exercises you should do every day to help speed up your recovery.
Your arm or wrist may be stiff and weak after the cast is removed. A physiotherapist can help with these problems, although sometimes they can last several months or more.
Will I Need Surgery
In most cases, these conservative healing methods are enough. But if you have a particularly severe or complex fracture, surgery may be required because a cast wont be enough to help the bone heal correctly.
Surgery may involve the insertion of pins, screws, plates, or other devices to hold your bones in place to heal. We may recommend surgery in the following cases:
- A piece of bone has broken through your skin
- You have a bone broken in multiple places
- Your break extends into the wrist joint
- The broken pieces of bone have moved out of place
- Pieces of bone have injured a blood vessel or nerve
- You tore ligaments along with the break
If you suspect youve injured a wrist and have pain, tenderness, swelling, bruising, or apparent deformity, make an appointment with our experts at Maryland Orthopedic Specialists.
We can diagnose a fracture and get you the treatment necessary to heal and restore function. either our Bethesda or Germantown, Maryland, office or use our online system to schedule a consultation.
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Evaluation: How Is A Wrist Fracture Diagnosed
If the wrist is not deformed and your feeling in the fingers is normal and your pain is manageable, it may be possible to wait until the next day to be seen. If the wrist is deformed or your pain is not manageable or certainly if the fingers are numb or are not pink and warm, you should be evaluated more urgently. Your doctor will ask you questions about your injury and examine your hand and wrist.
X-rays are the first line test to assess for a broken bone. X-rays show if the bone is broken and how severely it is angled or displaced.
Occasionally if the X-rays are inconclusive or if there are multiple pieces, a CT scan will be obtained to better assess for a fracture and whether or not surgery is necessary.
Occasionally, if there is suspicion for a ligament injury in addition to the fracture, an MRI will be obtained to better evaluate the ligaments and soft tissue structures of the wrist.
What Is The Scaphoid
The scaphoid bone is one of the eight smaller carpal bones in your . It lies on the thumb side of your wrist right below the , one of the two larger bones in your forearm. Its involved in moving and stabilizing your wrist. An older name for it is the navicular bone.
You can find your scaphoid bone by holding your thumb up as you look at the back of your hand. The triangular indentation thats formed by the tendons of your thumb is called the anatomic snuffbox. Your scaphoid is located at the bottom of this triangle.
The scaphoid has three parts:
- proximal pole: the end closest to your thumb
- waist: the curved middle of the bone that lies under the anatomic snuffbox
- distal pole: the end closest to your forearm
The site of the fracture affects how it will heal. Fractures in the distal pole and waist usually heal quickly because they have a good blood supply.
Most of the proximal pole has a poor blood supply thats easily cut off in a fracture. Without blood, the bone dies, which is called avascular necrosis. Fractures in the proximal pole dont heal as well or as quickly.
What Is A Fractured Wrist
A fractured wrist is actually a break in the larger of the two bones in the forearm. The bone on the lower end breaks in the area where it connects to the thumb side of the wrist. The wrist consists of eight small bones connecting to the two long forearm bones: the radius and ulna.
Certain wrist fractures are worse than others. A non-displaced break, for example, is when the bones stay in place, whereas displaced breaks mean the bones will need to be put back in place, likely via a cast or splint.
Fractures that break apart joint surfaces or shatter into many different pieces are far more severe. Such fractures will usually require surgery to correct their alignment.
You may have a fractured wrist if you are experiencing the following symptoms:
- Pain while flexing your wrist
- Wrist deformity
What Are The Causes Of A Broken Wrist
Your wrist joint is made up of several bones. These include the 8 carpal bones, the radius and the ulna. Any of these bones can break. However, the more common wrist fractures include:
- distal radius and ulna fracture
- scaphoid fracture.
The cause of a broken wrist is usually due to a fall on to an outstretched hand. Other causes include:
- serious accidents such as motor vehicle accidents
- a break that occurs in a weak bone, such as if you have .
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Reasons To Take Out A Plate And Screws
Surgeons leave plates and screws in most of the time, but there are some situations that may make the surgeon or patient more willing to take out the hardware:
- irritated tendons
- prominent screw or hardware too close to a joint
- a broken plate or screw
- a loose screw
- continued pain
- metal allergy
- Just get this thing out of me!
What Causes A Scaphoid Fracture
stands for fall onto an outstretched hand. Its the mechanism behind many upper limb fractures.
When you sense you are about to fall, you instinctively react by cocking your wrist and extending your arm to try to break the fall with your hand.
This protects your face, head, and back from injury, but it means your wrist and arm take the full force of the impact. When it causes your wrist to bend back farther than its meant to go, a fracture may occur.
The angle of your wrist when it hits the ground affects where a fracture happens. The farther your wrist is bent back, the more likely it is that your scaphoid bone will break. When your wrist is less extended, the radius bone takes the force of impact resulting in a distal radius fracture .
A FOOSH injury commonly affects the scaphoid because its the main connection between your hand and forearm. When you fall on your hand, all of the energy produced when your hand hits the ground travels to your forearm through the scaphoid. The force puts a huge amount of stress on this small bone, which can cause a fracture.
FOOSH injuries occur in many sports, especially things like skiing, skating, and snowboarding. Wearing a wrist guard is an easy way to prevent these injuries.
Participating in sports that repeatedly stress your scaphoid bone, such as shot put or gymnastics, can also cause a scaphoid fracture. Other causes include a hard blow directly to your palm and motor vehicle accidents.
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Broken Wrist Complications After Cast Removal And Physical Therapy
The wrist is a complex joint made up of eight bones, plus the radius and ulna, the two bones in the forearm. “Broken wrist” can refer to a fracture of any, some or all of these bones. Complications after a fractured wrist can include continued aching or stiffness, nerve or blood vessel damage, arthritis, infection, nonunion, avascular necrosis and carpal tunnel syndrome.
Recovery: What Can Be Expected
Distal radius fractures generally take about 6 weeks for the bone to heal. But there is a wide range in severity of these injuries and it can take several months for the soft tissues to heal and to regain motion, strength and function. Pain is usually managed with keeping the hand elevated, ice, over-the-counter medications such as acetaminophen or ibuprofen. Occasionally, stronger prescription opioid medications may be prescribed for a few days following the injury or surgery. How much use of the hand is permitted depends on the severity of the injury. Initially, the cast or surgical splint must be kept clean and dry with a bag over it while showering. Washing the hand is often allowed when the cast or surgical splint is removed. After 6 weeks if the wrist is healing appropriately, therapy is often started and activities and use of the hand and wrist can be gradually advanced as tolerated.