Houston Methodist. Leading Medicine

Wrist FAQ

Question:

I broke my wrist about six weeks ago. Fell off a ladder (dumb! I know better). I opted to go with closed reduction. They did put me to sleep and then put the bones back in place. I wore a special sling called a sugar-tong splint (I think that's the right name). Now that I'm back to "normal" (splint off, back to work), I notice a bump along the top of my wrist. I don't have full motion or strength yet. Will this all correct itself in time?

Answer:

Splints are often used in the emergency department to provide support and limit motion when there is a fracture or soft tissue damage. The type of splint you mentioned is meant to provide support and comfort through stabilization of the fracture. A sugar-tong splint keeps the injury from causing further harm or getting worse until you can be evaluated by a consultant such as an orthopedic surgeon. At that time, the best course of treatment is decided. That may be to remove the splint and apply a cast or perhaps a surgical procedure. Patients with injuries that are splinted are usually referred for a follow-up evaluation by an orthopedic surgeon. Patients are either advised to make an appointment or an appointment is made for them shortly after the emergency department visit. Depending on the severity of the injury, this can vary from 24 hours up to two weeks. You didn't mention this step in your treatment. The fact that you have a visible deformity may be the result of missing this step. Or if you did receive the necessary follow-up, perhaps the degree of deformity is minimal and the surgeon expects it will recover in time. If you are not being followed by a specialist, now would be a good time for a consultation. If you do have a surgeon who has been working with you all along, it may be a good idea to schedule a follow-up visit. You can find out if this is something serious or likely to recover in time. Studies show that the degree of deformity (called dorsal angulation (e.g., zero to 10 degrees, zero to 15 degrees, more than 10 degrees, more than 15 degrees) may dictate the results. As you might expect, the larger the angle, the more severe the injury, and the more chance that further treatment is needed. Likewise, the more deformity is present in the wrist, the more likely you would have some measurable loss of motion and function. But this correlation between severity and function is not closely tied so it is possible to have bony disruption but good results. In other words, a bony deformity does not automatically mean worse results. Aakash Chauhan, MD, and Gregory A. Merrell, MD. Functional Outcomes After Nonsurgical Treatment of Distal Radius Fractures. In The Journal of Hand Surgery. December 2012. Vol. 37A. No. 12. Pp. 2600-2602.

*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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