Operation of a broken wrist

Wrist fracture surgery

With a good 20-25% of all Fractures, is the as distal radius fracture, or colloquially as Broken wrist designated Broken bone the wrist is the most common on the entire body. On the one hand they are Carpal bones very fine and unstable bonewhich can be damaged even with a small amount of force. On the other hand, the exposed anatomical position of the hand and the Wrist to a higher one risk of injury. Typically elderly patients are of one Broken wrist affected, but also athlete, in particular Snowboarder, can injure themselves if they "fall down" incorrectly. As wrist factors usually complicated fractions conservative methods are usually not sufficient to optimally treat the fracture. How to get around one OP not around. But how is such a wrist fracture operation carried out, what are the risks and what is the chances of recovery?

OP

First of all, in recent years the guideline has also become established in trauma surgery to only operate when all other options have been exhausted, quasi as "Ultima ratio". Accordingly, first of all is one conservative treatment option to consider. At a Broken wrist conservative restoration is possible if the fracture is not displaced, i.e. the fracture edges are not shifted against each other. If the bone fragments are shifted against each other, one must first Repositioning take place: To do this, the bone fragments are put on tension, so to speak pulled apart. After about 10 minutes of pulling, the pieces of bone are then aligned again from the outside. Then one must Plaster plant for at least 6 weeks be done, as well as a regular Follow-up check by X-rayto prevent the repositioned bone parts from slipping back.

The conservative treatment is logical not with multi-part fractures possible, which may still be Splinter, or smallest Bone fragments have formed. These would be impossible to bring back into the correct position "from outside". Therefore in such cases need operational procedures be applied: One distinguishes the open, and the closed Reduction.

With the closed reduction, the wrist fracture is first x-rayedto get an idea of ​​the size and location of the bone fragments. After that, the individual bone fragments with Wires fixed together. These wires will too "Kirschner wires" called, and remain in the bone. The fact that they press the bone fragments tightly together promotes healing. It's like gluing two pieces of wood together using a wooden press. disadvantage this method, however, is that the wires not so stable are that they could withstand everyday forces. Therefore a Plaster splint for about. 6 weeks be created. The cuts for the Kirschner wires are usually made on the Inside wrist made through small incisions in the skin. After 6 weeks, the wires also have to be removed again, which is, however, under local anesthesia („Local anesthesia“) Can be done.

The second operative option is the open reduction dar: you will usually at complicated fractions applied, or when the bone is through osteoporosis is already very unstable. To do this, the pieces of bone are plate fixed. The plate is made of titanium and is a few millimeters thick. It is preferably placed on the flexor side of the Wrist - so the one Inside wrist - appropriate. It is then located directly under the skin, and can often be felt from the outside. The bone fragments are placed on it like a puzzle and screwed tight. This ensures immediate exercise stability so that physiotherapy can be started days after the operation. The record is also rarer on the Extensor side of the wrist used, but more here Tendons run, this method will reluctantly chosen: Often it comes to Irritation of the tendonswho the finger supply. The plate is left permanently in the wrist, as removal is usually not necessary. The operation is performed under local anesthesia and takes - depending on the complexity - half an hour to a full hour.

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Complications

Since that wrist a very complicated, and often used joint complications can also arise here. However, these mainly concern the conservative form of therapy, as there is a risk of one crooked growing together consists. Hence, it is means of conservative therapy sole plaster fixation also very important to regularly via X-ray examination to check whether the break is growing together in the correct position. If this is not the case, it can Misalignment, attached to Pain, up to Loss of function be the consequence.

During the surgical procedure, in addition to the usual complications that an operation brings with it, the wrist especially annoy or Blood vessels get hurt. The former are particularly important on the hand, as we rely on a particularly good hand area in everyday life Sensors and Motor skills are instructed. Injuries to the nerves can occur in Numbness, Restriction of movement, and Inoperability result. Since the wrist fracture operation is now a routine operation, these cases have become relatively rare.

Another complication that affects all joint fractures is the genesis one arthrosis. Osteoarthritis is by definition an unusually high level Joint wearwho are older than normal. This can take place after surgery if the joint surfaces are not 100% correctly aligned with one another, like a hinge that is not well oiled: In the long run, the friction causes wear and tear on the movement surfaces, which is known as osteoarthritis.

Pain

Every break brings Pain with itself, as the highly sensitive periosteum, that Periosteum, with many small ones annoy is streaked. An irritation of these nerves, as in one Broken bone occurs, results in severe pain. Initially the pain can be with NSAIDs (non-steroidal anti-rheumatic drugs) like Ibuprofen, or Paracetamol be fought. Often the fracture only hurts immediately after the fracture, and then only when moving. So there are some on the way to the hospital Relieving posture and if possible little movement advisable. Painkillers are usually given during the operations Opioids how Morphine, or Fentanyl. After the operation, the tissue is natural swollen, there blood and Tissue fluid have left. The swelling can increase Nerve fibers press and cause further pain. However, it usually goes back within a week, as excess fluid in the fracture area is then reabsorbed by the body. Until then, pain medication can be taken. In general, no patient should or should feel pain, and should this be the case, he has a right to analgesic treatment.

Aftercare

A Aftercare is especially true for broken wrist important. Means physical therapy and Rehab an attempt is made as early as possible to restore the original freedom of movement. After 6 weeks of immobilization, Muscles regressed, Tendons shortened. The task of physiotherapy is now to do that Functionality of the hand gently restore. But even after an operation, many patients feel insecure and do not know how much they can trust their hand. Therefore, in a multidisciplinary team, the patient gets used to his everyday tasks again, so that a smooth transition between discharge from the hospital and resumption of an independent life is possible.