Houston Methodist. Leading Medicine

Wrist FAQ

Question:

Mom fell and broke her wrist while she was staying with our family. We took her to the hospital and they put a cast on her arm. Now there's a dispute with my brother because her wrist looks crooked. He's blaming me for not taking her right to a specialist. She says her wrist feels and works perfectly fine. Would she have gotten a different treatment with a specialist?

Answer:

Wrist fractures are common in older adults. In particular, distal radial fractures receive a lot of attention. The radius is one of two bones in the forearm (located on the thumb side of the forearm). With a fall or traumatic injury, fracture at the end of the bone at the wrist can be considered unstable if the broken pieces have shifted and no longer line up as they should. Surgery may be done to reset the bone and hold the two ends together until healing takes place. But there are some studies that suggest invasive surgery in older adults with this type of fracture may not be needed. Results can be just as good with cast immobilization (and without the stress of surgery). Like your mother, with just cast immobilization, there may be a visible change in appearance of the wrist but everything works just fine. It's possible (even likely) that had you taken your mother to a specialist, she might have had the surgery and now have a straight, even wrist. Would she be better off? Not necessarily. There are risks with surgery (e.g., infection, poor wound healing, blood clots, even death) that can't always be predicted or prevented. And the cost of the additional treatment can be quite significant, too. You were right to take her to the facility that could provide immediate diagnosis and care. It's really up to the health care professionals to make the recommendation of the best treatment. Putting her in a cast right away may have been indicated as the optimal plan of care given the type of fracture, her age, her general health, and any other factors present at the time of admission. K. A. Egol, MD, et al. Distal Radial Fractures in the Elderly: Operative Compared with Nonoperative Treatment. In The Journal of Bone and Joint Surgery. August 2010. Vol. 92-A. No. 9. Pp. 1851-1857.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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