Fractured wrist bone

introduction

A Fractured wrist bone is one of the most common Injuries after falls and in sports. The wrist is anatomically relatively complicated built up, and therefore in places depending on the type of fracture difficult to take care of.

As a wrist, on the one hand, the Joint between ulna, radius and carpal bones called (also "proximal wrist"), on the other hand that joint, which is between the front and back row the carpal bone is also located ("distal wrist").

Proximal stands for "closer to the body", distal for "further from the body". A is just as complicated as the definition Broken bone in this area.

With good 25% of all broken bones however represents the Colles extension fracture (also Colles fracture) is the most common human fracture. It is one Fracture of the proximal wrist between ulna and radius. In addition to this type of fracture, there is one Range of other fracture mechanisms, which will be discussed further below. In the Amount and complexity when it comes to fractures it is not surprising that the Hand surgery forms its own specialist area (specialist in plastic, hand and reconstructive surgery).

Symptoms

Depending on Severity can be a broken bone on the wrist various symptoms cause.

At very severe fractures of the proximal wrist, for example after car accident And if you fall from a great height, you can already break the break diagnose by looking at it alone. It can become a Impaling the skin through the bone, or abnormal mobility come in the wrist.
Also so-called Crepitation noises, in German Creaking noises when moving are a sure sign for a broken bone. A break also goes on with pain and swelling in the fractured area.
The pain occurs because the fine skin of the bone (medical: periosteum) very sensitive to pain is, and in the event of a break downright torn apart becomes. There are particularly many in it annoywhich, when irritated, give pain impulses to the brain send out.
A swelling arises through Lymph fluid leakage and blood into the surrounding tissue. Your will be best with immediate cooling prevented. (Incidentally, immediate cooling is required for almost all bruises and fractures recommendable!).
In addition to pain and swelling, there is also one Restriction of movement and relieving posture.

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root cause

Of the slang term "Wrist fracture" is relative spongy, and is therefore more precisely used in medical terminology different fracture forms divided. These are based on Injury pattern and place of injury.

Of the most common broken bones on the wrist is the one already mentioned Colles fracture to frontal fall on the hand. She comes in very often Skateboarders, Snowboarders and older people in front. The one behind it Injury Mechanism is that that complete weight of the upper body and the arms swing on the outstretched palm. Of the most unstable point between the upper body and the palm is the connection between ulna, radius and carpal bones - that is proximal wrist. It breaks at one strong force usually first in this area.

Opposite her stands the far less common Smith fracture after falling on the angled hand (so-called Inflectionfracture). You enter Fall on the back of the hand ahead. There one natural defensive movement if you fall forward that Extending the hands and arms is, is this violation relatively unusual.

Expressed in numbers, it is in 80% of fractures on the wrist by one Extension fracture, and only at 20% around a Flexion fracture. The two types of fracture mentioned, the Colles fracture and the Smith fracture, are Fractures of the proximal wrist. They are also called distal radius fracture referred to as the break, strictly speaking, not on the hand, but in the part of the spoke near the hand takes place. Because the ulna, radius and carpal bones come together form part of the wrist (namely the proximal part), they are also referred to as a fracture on the wrist.

To make it a little more complicated you can use the distal radius fracture further in extra-articular, partial and complete joint fractures subdivide. It is stated that to what extent the proximal wrist is affected, and how badly it fractures is.
During Colles and Smith fracture the two major fractures of the proximal wrist are is a distal wrist fracture far less often. This is one Broken bone (or several) at the lower palm. If you look at the palm of your hand, you will find it Carpal bones in the area of ​​the heel of the hand - but they take Carpal bones by no means the entire palm of your hand! Circa at the level of the thumb already close the Metacarpal bones on. There are eight carpal bones in the hand. Any of these bones can fracture, but the mechanisms behind them are not particularly specific.
Mostly they appear as Accompanying fractures in a Colles or Smith fracture on when the Violence was too strong on the palm. Since each of the carpal bones has a proper name, one speaks of one Scaphoid fracture or one Scaphoid fracture, depending on what bone broken is. There are still between the individual carpal bones Jointswho have broken bones get damaged can.

Other causes for a wrist fracture are next to a fall in general age and accompanying osteoporosis. With age, they take Bone density and thus the Resilience of the bone clearly. This will be Bones more unstable and break easier. Also, the risk of falling decreases with restricted mobility and impaired vision and hearing to. Overweight patient also put a special strain on their bones: On the one hand, it is a burden at all times increased weight on their bones. On the other hand, the increased weight creates an in the event of a fall significantly higher force on the wrist, thus promoting breakage.

therapy

The Treatment of the fracture occurs as with any other bone fracture by immobilization and if necessary operative care. Appears in roentgen the fracture is complicated (e.g. comminuted fracture) supplied by screws and / or plates become. For this purpose a Metal plate screwed to the bonewhich then holds the individual pieces of bone together. This can be either left in the bone or removed after the healing process is complete.

At "Simple" straight fractions the bone is first repositioned - i.e. in the original, anatomically correct one Set back. This is done using a "Chinese finger trap": One or more fingers are hooked into a device at head height, and the elbow by means of weight down drawn. This will make the Fracture pulled apart, and can after about 10 minutes be repositioned. After that the break using a plaster cast immobilized - including the adjacent two joints. In this case from the elbow to the fingers.

To about 6 weeks healing time the bone has grown together again and is gently resilient. Against the pain you can NSAID-class pain relievers be taken, but always with a stomach protectant must be combined as they are the Gastric mucosa attack.

diagnosis

The Diagnosis of a broken bone at the wrist is established either clinically on the basis of certain or uncertain fracture signs:

• Safe fracture signs are for example abnormal misalignment of the bone or Creaking noises when moving.
• Unsafe fracture signs such as swelling, pain, and restricted mobility may indicate a fracture, but apply not as proving.

A X-ray image becomes a diagnosis made in almost every case, because - if there is a fracture - this too judge more closely want to be able to. This is especially for that Type of therapy and assessment the severity is important.

forecast

Depending on Severity of the break can healing absolutely uncomplicated to unfavorable run away.

At severe and complicated fractures remains one in many cases Restriction of movement that has persisted for years in the wrist back. The wrist is a very complicated jointwhich is moved many 100 times a day. It must extraordinary burdens and claims suffice. As a result, the initial state is often no longer achieved. physical therapy and rehab can, however great support be.

At elderly patients is the downright "rotten" structure of the bone a big problem: screws or plates do not hold in the bone, and if you try to drill it there is a risk of further fracturing it. These operations are therefore not always successful. At younger patients with less complicated fractions, however good cure rates educates.

prophylaxis

For elderly patients recommends a Fall prevention. This aims to eliminate possible causes of a fall. Such causes of falls can internalistic nature be (for example Heart attack or Loss of consciousness) but also neurological (stroke, too strong medication with sleeping pills).

The Sources of fall with a subsequent bone fracture are unfortunately diverse. Also must be completely natural pitfalls such as carpets, cables lying around, wet floors, or unsuitable footwear. For athletes in Snowboard or skateboard area there are specially Wrist guardsthat protect the wrist with a plastic splint. Such protectors cost no more than 20 euros, and are available in every sports shop. Since the wrist fracture is the most common bony injury in snowboarding, they have most snowboard gloves This plastic splint is integrated at wrist height as standard in order to prevent a bone fracture on the wrist. In addition, in beginner courses the first thing to do is the "right falling" learned on the forearms. So there are definitely options one protracted wrist fracture to prevent.