The best care

Wrist fractures are one of the most common fractures among individuals over the age of 60, secondary to falls on osteoporotic and weak bones.  These fractures in younger individuals are associated with falls from heights as well as trauma. The primary bones of the wrist are comprised of the distal radius and ulna (forearm bones) and the carpal bones of the hand.  These fractures are often amenable to conservative treatment with either application of a cast or a closed reduction (general anesthesia to put the patient to sleep and application of pressure to the fracture site to stabilize and realign the fracture) and application of a well molded and well padded short or long arm cast. Occasionally, surgical intervention is warranted for these fractures. Surgery is indicated if the fracture involves the articular (joint cartilage) surface and/or has multiple pieces with accompanying displacement and excessive angulation. If not surgically repaired, an acceptable functional outcome may not occur resulting in a malunion or poor position.  These fractures can be treated with various options, including pins or percutaneously placed screws versus application of an external fixation device (i.e., erector set with pins and bars to the outside of the arm).  The treatment of choice for most wrist fractures which require surgical intervention is open reduction internal fixation with plates and screws, either to the distal radius (forearm bone) with or without bone grafting of the segmental or impacted defect.  Each case is different and the ultimate decision on your plan of care should be decided between you and your physician.