Treatment for a broken wrist in which the bones are not significantly displaced usually involves wrapping the wrist in a plaster cast until it heals. If the bones are not aligned correctly, surgery may be needed to correct the deformity and allow the wrist to heal properly. The decision to undergo surgery for a broken wrist should involve the consideration of many different factors, including:
- Age and overall health of the patient
- Bone quality
- Location of the fracture
- Degree of displacement
- Effectiveness of nonsurgical treatment
Surgery for a broken wrist typically involves the use of metal plates, screws or pins to hold the bone in place while it heals, ensuring that full function will be restored.
Some patients may also benefit from external fixation treatment, which involves the use of pins and a device outside the skin to align the bones back into position. This treatment avoids the need for an incision. Your doctor will decide whether or not surgery is right for you after a thorough evaluation of your condition.
TFCC and Ligament Injuries
The triangular fibrocartilage complex (TFCC) is a small piece of cartilage and ligaments on the side of the wrist at the end of the ulna bone that helps cushion the joint. This area may be injured as a result of a fall onto outstretched hands, a direct blow to the hand or a twist of the wrist, causing the ligaments and/or cartilage to tear.
Patients with a TFCC tear may experience pain in the affected area and a clicking sound when moving the wrist. Your doctor can diagnose this condition by examining the hand and performing an X-ray exam. Arthroscopy may also be performed to confirm the diagnosis of the tear.
A TFCC tear can usually be treated through a combination of nonsurgical methods that may include:
- Applying ice to the wrist several times a day
- Wearing a splint or cast
- Taking anti-inflammatory medication
- Performing rehabilitation exercises
- Receiving steroid injections
Wrist tendonitis (also called deQuervain's tendonitis or tenosynovitis) is an inflammation of the tendons that cross the wrist and attach to the thumb. If you have deQuervain's tendonitis, it hurts to bend, extend or turn your wrist or form a fist with the thumb tucked inside.
Activities such as writing, knitting and gripping something with your hand become uncomfortable. Pain is usually located in the front of the wrist and worsens with activity. Other symptoms include sensitivity to touch, limited mobility, and wrist weakness.
There are many causes of tendonitis of the wrist, including:
- Biomechanical problems
- Arm injury
- Overuse/repetitive motion (such as throwing, catching, bowling, typing or sewing)
- Starting a new exercise/activity
- Inflammatory arthritis
If detected early, tendonitis can be treated with steroids or anti-inflammatory medications. Advanced cases may require surgery.
Arthritis of the Wrist
Arthritis in the wrist is less common than in the base of the thumb or in the DIP joints adjacent to the finger nail. Most of the arthritis seen in the wrist follows injury from years earlier. Typically the patient broke a bone in the wrist (scaphoid) and it went untreated for years. Or the patient fell and tore ligaments in the wrist and years later the unstable wrist became arthritic.
Even without injury, arthritis can appear in the wrist. The most common location is between three of the small bones in the wrist: the scaphoid, the trapezium, and the trapezoid. These three bones form joints just below the thumb basal joint. The pain is aggravated by leaning on the hand as in doing certain yoga poses. Any attempt to do a push-up often hurts.