Care for Broken Bones in the Hand and Wrist

If you suffer a broken bone in your hand or wrist, you want it to heal the right way so you can regain the function you need

A fracture, or broken bone, occurs when enough force is applied to a bone to break it. Some fractures are simple, with the bone pieces aligned and stable. Other fractures are "displaced," or unstable, causing the bone fragments to shift. Each type of fracture requires specialized care to make sure you regain full use of your hand and wrist.

Hand Fractures and Dislocations

Your hand is made up of many bones that form its supporting frame. This frame holds the muscles, tendons and ligaments that make your wrists and fingers move. When one of the bones breaks, you may have pain and stiffness, and lose the natural movement and use of your hand.

Some fractures are easy to see, causing a crooked finger or other abnormality. But many fractures are not. Because of the close relationship of bones to ligaments and tendons, you should see one of our specialized hand surgeons to get the correct diagnosis and treatment. This will prevent the hand from becoming stiff and weak after the fracture heals.

Our surgeons also diagnose and treat a dislocation of one of the three bones in the hand—the lunate, perilunate and scaphalunate bones. This is called intercarpal dislocation. If not recognized and corrected surgically, this condition may result in long-term disability.

Wrist Fractures and Sprains

Your wrist is made up of eight small bones and two forearm bones, the radius and ulna. A fracture may occur in any of these bones when enough force is applied, most commonly when you fall down onto an outstretched hand.

Most wrist fractures are on the scaphoid bone, located on the thumb side of your wrist. The biggest challenge in treating wrist fractures is keeping the bones in alignment during healing. If bones shift, your wrist can become misshapen and not function well, causing long-term problems like arthritis and loss of motion.

Wrist sprains can be as difficult as fractures to treat. Sprains result when the ligaments are stretched and strained. Like fractures, if a serious wrist sprain or ligament tear is not treated properly, it can affect how your wrist functions and cause long-term problems.

Treatment for Fractures

Our hand surgeons evaluate your hand and wrist carefully to determine the treatment. After they determine whether it is stable or unstable, they recommend your treatment. Other important considerations include your age, overall health, work and leisure activities, the presence of any prior injury or arthritis and any associated injuries.

Depending on the type of fracture, your hand surgeon may recommend several treatments:

• A splint or cast is used to treat a fracture in which the bones are stable and aligned, or to protect a fracture that has been set.
• Surgery may be necessary to set the bone and stabilize it. Once the bone fragments are set, they are held together with pins, plates or screws.
• Fractures that have been set may be held in place by a set of metal bars outside the hand (called an external fixator) that are attached to pins placed in the bone above and below the fracture site.
• A permanent plate (called an internal fixator) may be put in the wrist. This secures unstable fractures and promotes faster healing.
• Sometimes the break is serious enough that a bone graft may be necessary. Bone is taken from another part of the body to help provide more stability.
• For both fractures and sprains, hand therapy plays an important role in the healing process, helping you recover faster and regain full strength and mobility in your wrist.

Repairing Fractures From Inside Your Wrist

Sometimes our hand surgeons use a minimally invasive technique of seeing and treating the inside of the wrist. This is called arthroscopy. They insert a tiny camera and surgical instruments through small incisions to diagnose and sometimes treat the hand or wrist. Pain, swelling and stiffness are usually minimized, and recovery is faster.

Arthroscopy also is used to repair a tear in the wrist cartilage (called triangular fibrocartilage complex). During this procedure, our surgeons trim out the torn fragment or repair the torn edges of the cartilage to relieve pain and restore function.

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