Wrist Fractured: Causes, Symptoms & Treatments

Article featured on the American Society for Surgery of the Hand

A wrist fracture is a medical term for a broken wrist. The wrist is made up of eight small bones which connect with the two long forearm bones called the radius and ulna. Although a broken wrist can happen in any of these 10 bones, by far the most common bone to break is the radius. This is called a distal radius fracture by hand surgeons.

Some wrist fractures are stable. “Non-displaced” breaks, in which the bones do not move out of place initially, can be stable. Some “displaced” breaks (which need to be put back into the right place, called “reduction” or “setting”) also can be stable enough to treat in a cast or splint. Other fractures are unstable. In unstable fractures, even if the bones are put back into position and a cast is placed, the bone pieces tend to move or shift into a bad position before they solidly heal. This can make the wrist appear crooked.

Some fractures are more severe than others. Fractures that break apart the smooth joint surface or fractures that shatter into many pieces (comminuted fractures) may make the bone unstable. These severe types of fractures often require surgery to restore and hold their alignment. An open fracture occurs when a fragment of bone breaks and is forced out through the skin. This can cause an increased risk of infection in the bone.

Causes

A wrist fracture occurs from an injury such as falling down onto an outstretched hand. Severe trauma such as car accidents, motorcycle accidents or falls from a ladder cause more severe injuries. Weak bones (for example, in osteoporosis) tend to break more easily.

Signs and Symptoms

When the wrist is broken, there is pain and swelling. It can be hard to move or use the hand and wrist. Some people can still move or use the hand or wrist even if there is a broken bone. Swelling or a bone out of place can make the wrist appear deformed. There is often pain right around the break and with finger movement. Sometimes the fingers tingle or feel numb at the tips.

Diagnosis

Your hand surgeon will do a physical examination and obtain x-rays to see if there is a broken bone. Sometimes, tests such as a CT scan or MRI scan may be needed to get better detail of the fracture fragments and other injuries. Ligaments (the soft tissues that hold the bones together), tendons, muscles and nerves may also be injured when the wrist is broken. These injuries may need to be treated also.

Treatment

Treatment depends on many factors, including:

  • Type of fracture, whether it is displaced, unstable or open
  • Your age, job, hobbies, activity level, and whether it is your “dominant” hand
  • Your overall general health
  • Presence of other injuries

A padded splint might be worn at first in order to align the bones and support the wrist to provide some relief from the initial pain. If the fracture is not too unstable, a cast may be used to hold a fracture that has been set. Other fractures may benefit from surgery to put the broken bones back together and hold them in correct place.

Fractures may be fixed with many devices. Pins, screws, plates, rods or external fixation can all be used. A small camera might be used to help visualize the joint from the inside. Sometimes the bone is so severely crushed that there is a gap in the bone once it has been realigned. In these cases, a bone graft may be added to help the healing process. Your hand surgeon will discuss the options that are best for your healing and recovery.

Recovery

During recovery, it is very important to keep your fingers moving to keep them from getting stiff. Your hand surgeon will have you start moving your wrist at the right time for your fracture. Hand therapy is often helpful to recover motion, strength and function.

Recovery time varies and depends on a lot of factors. It is not unusual for recovery to take months. Even then, some patients may have stiffness or aching. Severe wrist fractures can result in arthritis in the joint. Occasionally, additional treatment or surgery is needed.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Bone Fractures: 10 Things Doctors Want You to Know

Mending Your Bone Fracture: What Doctors Say

About 6 million people break bones in the United States every year. The most frequently broken bone is the clavicle, or collarbone. Other common bone fractures include those in the arms, wrists and ankles. If you’re over 65, you’re more likely to break your hip than any other bone. You can break bones due to injury or diseases like osteoporosis, which weakens bones. Orthopedic surgeons specialize in treating broken bones in all scenarios. Here’s what three board-certified orthopedists want you to know about bone fractures, risk factors associated with them, and tips for helping them heal properly.

1. “A fracture and a break are the same thing.”

Patients frequently think bone fractures and bone breaks are different. Sometimes people think “fracture” means a crack while “break” means a clearly separated bone, but this is not true. “Fracture” is simply the term doctors use to refer to any break or crack in a bone.

2. “If you smoke, your fracture might not heal as fast.”

If you ingest nicotine—whether through cigarettes, cigars, chew tobacco, or even the nicotine patch—you may find that your fracture takes longer to heal than for a non-smoker. This is due to the effect of nicotine on the healing process. If you quit smoking, it will take three months before your body responds to bone breaks like a non-smoker’s would.

3. “Try RICE for non-emergency injuries.”

If you have a broken bone cutting through your skin or your bones are looking crooked and weird (what doctors call a deformity), you need emergency medical care. But if you only have pain and swelling, and aren’t sure if it’s a break, he says, you could try treating your injury at home for a day or two with “RICE”: rest, ice, compression (wrapping with an ace-type bandage) and elevation. If that doesn’t work, then you can be seen by a doctor.

4. “Don’t wait too long to be seen.”

If you wait too long to bring your possible bone fracture to your doctor’s attention, your bone could start healing on its own—and possibly in a crooked way. That makes fixing the problem more difficult than if you’d come in earlier. Or you could have underlying damage to the surface of the joint or other problems that are harder to treat the longer you wait. Waiting can also make it more likely you’ll need surgery. For non-emergency fractures it is recommended patients be seen within a couple of days. If you require an operation, this gives you time to get it scheduled before bones start knitting back together (which usually happens within a few weeks).

5. “Even little fingers and toes need to be checked out.”

You crack your little toe against a table leg. Should you bother getting it checked for fracture? It depends how bad you feel, noting that in similar situations, he might wait a couple days and, if still in pain, see a doctor to have it X-rayed. But in general, it’s better to err on the side of caution and see your doctor. After all, broken toes that heal crookedly can cause your shoes not to fit right, resulting in pain. Similarly, ignoring finger fractures can cause “significant disability” and lead to longer surgeries once patients finally come in, he says.

6. “Moving it doesn’t mean it is not broken.”

Patients say they didn’t think their bone was broken because they could still move the affected body part. But, he says, this is a fallacy. There’s only one way to know if it’s broken and that’s with an X-ray. The idea that if I can move it, therefore it can’t be broken is ridiculous. You can almost always move it, even if it is broken. Signs that it could be a bone fracture include significant swelling, tenderness around the site, bruising, and an inability to bear weight on it even after a couple of days’ rest. 

7. “I don’t always operate.”

People think orthopedic surgeons do surgery 99% of the time. This can cause some patients to avoid seeing them, because they think they’ll wind up in the operating room. It’s perhaps an understandable misconception, given that “surgeon” is part of his title. But, most of what they do isn’t surgery. Instead, orthopedists do the least invasive procedures possible first to promote bone fracture healing, only moving up to surgery if more conservative measures don’t work.

8. “When we tell you to elevate it, take us seriously.”

Folks come in a couple of days after a broken ankle, for example, and they may have been laying around on the couch but not with the ankle truly elevated—which is above the level of your heart. If you’re lying down, you can put two or three pillows under your leg to achieve proper elevation, but if you’re sitting, you’re going to have to use more than that to get your leg high enough. Elevation is key to preventing swelling, which also could delay surgery, if that’s needed.

 9. “Splints are not second-class citizens.”

Casts are non-removable and go all around your broken bone, while splints go only halfway around and can be taken off and on. Both casts and splints are used to immobilize your broken bone and both can be written on and decorated. Yet some patients think casts are best and get disappointed if they get a splint instead. A lot of times patients don’t give the splint a lot of respect. Doctors use splints for several reasons, including when a cast is difficult to place due to the location of the break or when doctors want to leave room for swelling.

10. “Forget the ‘6-week rule’ of bone healing.”

Patients think they know fractures are cured in six weeks, which is an incredible piece of misinformation; no adult is going to heal in six weeks. Most bone fractures take anywhere from 2 to 6 months to heal, depending on many factors, he says. There’s not just one rule for every broken bone. It’s important to understand there is specificity and details matter, such as where a bone is broken, what bone it is, what the fracture pattern looks like, and so on. It’s difficult to generalize.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Understanding Bone Fractures: The Basics

Article featured on WebMD

What Are Fractures?

A fracture is the medical term for a broken bone.

Fractures are common; the average person has two during a lifetime. They occur when the physical force exerted on the bone is stronger than the bone itself.

Your risk of fracture depends, in part, on your age. Broken bones are very common in childhood, although children’s fractures are generally less complicated than fractures in adults. As you age, your bones become more brittle and you are more likely to suffer fractures from falls that would not occur when you were young.

There are many types of fractures, but the main categories are displaced, non-displaced, open, and closed. Displaced and non-displaced fractures refer to the alignment of the fractured bone.

In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends are not lined up straight. If the bone is in many pieces, it is called a comminuted fracture. In a non-displaced fracture, the bone cracks either part or all of the way through, but does move and maintains its proper alignment.

A closed fracture is when the bone breaks but there is no puncture or open wound in the skin. An open fracture is one in which the bone breaks through the skin; it may then recede back into the wound and not be visible through the skin. This is an important difference from a closed fracture because with an open fracture there is a risk of a deep bone infection.basic information on female sexual problemsBecause of the unique properties of their bones, there are some defined fracture subtypes that present only in children. For example:

  • A greenstick fracture in which the bone is bent, but not broken all the way through
  • A buckle fracture results from compression of two bones driven into each other.
  • A growth plate fracture at the joint that can result in shorter bone length

These fracture subtypes can present in children and adults:

  • A comminuted fracture is when the bone breaks into several pieces
  • A transverse fracture is when the fracture line is perpendicular to the shaft (long part) of the bone.
  • An oblique fracture is when the break is on an angle through the bone
  • A pathologic fracture is caused by a disease that weakens the bone
  • A stress fracture is a hairline crack

The severity of a fracture depends upon the fracture subtype and location. Serious fractures can have dangerous complications if not treated promptly; possible complications include damage to blood vessels or nerves and infection of the bone (osteomyelitis) or surrounding tissue. Recuperation time varies depending on the age and health of the patient and the type of fracture. A minor fracture in a child may heal within a few weeks; a serious fracture in an older person may take months to heal.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

Fracture After Total Hip Replacement

Article Featured on AAOS

A periprosthetic hip fracture is a broken bone that occurs around the implants of a total hip replacement. It is a serious complication that most often requires surgery.

Although a fracture may occur during a hip replacement procedure, the majority of periprosthetic fractures occur after a patient has spent years functioning well with a hip replacement. Fortunately, these fractures are rare.

The treatment of these fractures is often challenging because patients are older and may have thinning bone or other medical conditions.

Read more

Types of Shoulder Fractures

Shoulder fractures can result from a fall on the shoulder, a motor vehicle accident, contact sports, etc.

The shoulder is a complex joint connecting the arm to the body. The shoulder bones include the humerus (upper arm bone), the scapula (shoulder blade) and the clavicle (collarbone) (Figure 1). The upper end of the humerus has a ball-like shape that connects with the socket of the scapula, called the glenoid. Disruption of any of the parts of the shoulder can create difficulty with its function.

Types of Shoulder Fractures

The type of fracture varies by age. Most fractures in children occur in the clavicle bone. In adults, the most common fracture is of the top part of the humerus (proximal humerus). Some types include:

  • Clavicle Fractures: This is the most common shoulder fracture, frequently the result of a fall (Figure 2).
  • Scapula Fractures: Fractures of this bone rarely occur. They usually result from high-energy trauma such as motor vehicle accidents or a far fall.
  • Proximal Humerus Fractures: Fractures of the upper part of the arm are more common in the older (over 65 years of age) population. Sometimes, there are just cracks in the bones, but they have not moved very far out of their normal position.

Some fractures are diagnosed using x-rays. Sometimes, a CT scan is needed to see more detail.

Treatment

Treatment for these fractures can vary. Some options include:

  • Simple sling or “figure 8” strap worn for three to eight weeks, depending on the patient’s pain.
  • Surgery, which may include placing plates and screws or wires and sutures (Figure 3). This is more often needed when there is injury to the glenoid (shoulder socket) or when broken bone pieces are severely out of place.

Once healed, there may be a bump over the fracture site which may decrease with time, but sometimes a bump will remain permanently. Shoulder movement can begin as soon as pain goes away; return to sports cannot occur until full shoulder strength returns. Return to contact sports would be considered only when the fracture is fully healed as shown on an x-ray.

Selection of treatment depends upon the patient’s activity level, the location of the fracture and the severity of the fracture.

Recovery

Shoulder fractures may leave a patient with permanent shoulder stiffness, regardless of how well the bones were repaired or joint replacement performed. Recovery may require the use of physical therapy to assist in improving motion and strength. Consult your physician for the best option.


Orthopedic Sports Medicine Center of Oregon is located in Downtown Portland Oregon. Dr. Dominic Patillo, one of our Board-Certified Orthopedic Surgeons, specializes in hand surgery. His practice focuses on the treatment of both simple and complex hand and upper extremity conditions as well as general orthopaedic trauma. He is experienced with modern microsurgical techniques including nerve and vessel reconstruction.

Common problems treated include:

  • carpal tunnel syndrome
  • tennis elbow
  • wrist pain
  • sports injuries of the hand and wrist
  • fractures of the hand, wrist, and forearm
  • trigger finger

Other problems treated can include arthritis, nerve and tendon injuries, and congenital limb differences (birth defects).

If you have pain in your fingers, hand, wrist or arm, or if you have other upper-extremity related concerns, please consult our hand specialist Dr. Dominic Patillo for a consultation.

Will I Need Surgery on My Broken Or Fractured Finger?

Although the bones in the hand are small, a broken (fractured) finger is not a minor injury. The bones in a normal hand line up precisely. They let you perform many specialized functions, such as grasping a pen or manipulating small objects in your palm. When you fracture a finger bone, it can cause your whole hand to be out of alignment. Without treatment, your broken finger might stay stiff and painful.

Anatomy

Your hand consists of 27 bones: eight bones in your wrist (carpals), five bones in the palm of your hand (metacarpals), and 14 bones in your fingers (phalanges). Fractures of the metacarpal bone that leads to the little finger account for about one-third of all hand fractures in adults.

Cause

Generally, a fractured finger occurs as the result of an injury to the hand. You can fracture a finger when you slam your fingers in a door, when you put out your hand to break a fall, or when your finger jams while trying to catch a ball. Carelessness when working with power saws, drills, and other tools can result in a fractured finger.

Symptoms

  • Swelling of the fracture site
  • Tenderness at the fracture site
  • Bruising at the fracture site
  • Inability to move the injured finger in completely
  • Deformity of the injured finger

Doctor Examination

If you think you fractured your finger, immediately tell your doctor exactly what happened and when it happened. Your doctor must determine not only which bone you fractured, but also how the bone broke. Bones can break in several ways: straight across the bone, in a spiral, into several pieces, or shatter completely.

Your doctor may want to see how your fingers line up when you extend your hand or make a fist. Does any finger overlap its neighbor? Does the injured finger angle in the wrong direction? Does the injured finger look too short? Your doctor may x-ray both of your hands to compare the injured finger to the uninjured finger on your other hand.

Treatment

Nonsurgical Treatment

Your doctor will put your broken bone back into place, usually without surgery. You will get a splint or cast to hold your finger straight and protect it from further injury while it heals. Sometimes your doctor may splint the fingers next to the fractured one to provide additional support. Your doctor will tell you how long to wear the splint. Usually a splint on a fractured finger is worn for about 3 weeks. You may need more x-rays over this time so that your doctor can monitor the progress of your finger as it heals.

Surgical Treatment

Depending on the type and severity of the fracture, you may need surgery to put the bones into alignment. Small devices, such as pins, screws, or wire, will be used to hold your fractured bones together.

Rehabilitation

You may begin using your hand again as soon as your doctor determines it is okay to move your finger. Doing simple rehabilitation exercises each day will help reduce the finger’s stiffness and swelling. You may be required to see a physical therapist to assist you in these exercises.


Orthopedic Sports Medicine Center of Oregon is located in Downtown Portland Oregon. Dr. Dominic Patillo, one of our Board-Certified Orthopedic Surgeons, specializes in hand surgery. His practice focuses on the treatment of both simple and complex hand and upper extremity conditions as well as general orthopaedic trauma. He is experienced with modern microsurgical techniques including nerve and vessel reconstruction.

Common problems treated include:

  • carpal tunnel syndrome
  • tennis elbow
  • wrist pain
  • sports injuries of the hand and wrist
  • fractures of the hand, wrist, and forearm
  • trigger finger

Other problems treated can include arthritis, nerve and tendon injuries, and congenital limb differences (birth defects).

If you have pain in your fingers, hand, wrist or arm, or if you have other upper-extremity related concerns, please consult our hand specialist Dr. Dominic Patillo for a consultation.

Broken Arm: Signs, Symptoms, & Treatments

Description

A broken bone is commonly known as a fracture. Any bone in the arm can be broken, but common areas for fractures in the arm are:

  • Wrist, specifically the distal radius
  • Forearm bones (radius and ulna) (Figure 1A)
  • Elbow
  • Humerus
  • Shoulder

Causes

Most broken arms are caused by trauma. In younger people, common causes are falls from a height, sports injuries and motor vehicle accidents. In older people with weaker bones, a trip and fall from a standing height is a common cause of a broken arm.

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Fractures in Children: Causes, Symptoms, & Treatment

Description

Because children are still growing, their injuries need different evaluation, and sometimes different treatment.

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