The bones of the hand and wrist are some of the most unique structures in the human body. Made up of 27 bones, both large and small, the wrist and hand are highly susceptible to injury. A fracture can occur to any of the bones in the wrist or hand if enough force is applied. Typically, wrist or hand fractures are caused by car accidents, falling down, or other trauma. Osteoarthritis is a common condition typically affecting older individuals that causes the bones to become brittle and thin, leaving them susceptible to fracture. A fracture can be simple, with one or two bone pieces breaking while still maintaining stability, or a fracture can be unstable, in which the broken bone fragments shift, causing the wrist to look disfigured. In the case of a compound fracture, the bone will break the skin’s surface. A fracture to the wrist or hand can occur in one or more of the following locations:
Carpals: There are 8 carpal bones in the wrist that articulate the radius and ulna. Fractures in the carpal bones are often difficult to diagnose and can lead to permanent issues if left untreated. Typical causes of carpal fracture include car accidents, severe dislocation, falling, or other trauma.
Metacarpals: There are 5 metacarpal bones in the hand. The metacarpals are the intermediate bones that connect the carpal bones to the phalanges. A fracture occurring in the one of the metacarpals constitutes a broken hand. Fractures occurring in the metacarpal bones typically occur from fist fights, sports involvement, car accidents, or falling down.
Phalanges: There are 14 phalanges bones in the hand. The phalanges are the small bones that compose the top part of the finger. A phalangeal fracture typically occurs from direct trauma or twisting injuries. A fracture in the phalanges can cause loss of mobility and disrupt extensor and /or flexor mechanisms.
Radius: The radius is the large forearm bone that connects the elbow to the wrist. The end of the radius is referred to as the distal end. A fracture occurring in the distal radius occurs 1 inch from the wrist joint and can occur in many different ways. The most common cause of a distal radius fracture is a fall onto the outstretched arm.
Ulna: The ulna is the smaller forearm bone that connects the elbow to the wrist. Fractures of the ulna typically occur as a result of being struck by an object or hitting the arm with great force against an object.
Depending on numerous factors, including the severity of the fracture, age of the patient, dominance of the wrist and/or hand that is afflicted, and whether or not the fracture was influenced by internal factors such as osteoarthritis, Genesis Orthopedics & Sports Medicine will recommend different treatment options.
Treatments of fractures depend on the severity of the injury. If the fracture is minimally displaced or non-displaced treatment options include bracing or the use of a cast often supplemented by physical therapy. The ultimate goal of bracing and/or a cast is to allow the fracture to heal naturally and cause no further damage. Physical therapy is used to ensure that the muscles in the affected area do not atrophy and full range of motion is restored.
Displaced fractures or multi-fragmented fractures impact range of mobility and require further intervention. Surgery is a treatment option often utilizing structural aids such as pins, wires, screws, plates, sutures or a combination of these methods. If the affected bone is not able to regain its original shape a bone graft or artificial replacement may be necessary.