Your hand and wrist are a critical part of your everyday function. Until we injure we take these functions for granted. No one ever thinks it will happen to them but sustaining wrist fractures are an all too common type of injury. Whether it is from icy, wintry conditions or a loose carpet causing you to slip this injury should be treated to ensure the best outcome possible. Having assessed and treated so many patients with wrist fractures over the last 35 years I have seen the value of an individualized program of exercise and “hands-on” physiotherapy after wrist fractures. I have found that this approach gives you the best chance of getting your life back to normal as quickly as possible.
If you have recently broken your wrist here’s what you want to know about the injury and what to expect from your therapist during a rehab program.
Why do we break our wrists?
Injuries to our wrists and arms occur when we fall as we instinctively reach our arms out for protection. Wrist fractures can easily be caused when you land hard on your hands. As you land on the palm of your hand the wrist is forced backwards adding a bending force to the bone in the forearm. The commonest fracture in the arm is the “Colles” fracture, a break of the radius bone (one of two forearm bones, the other is called the ulna). In medical jargon we call this a “FOOSH” injury. A fall (F) on (O) the out-stretched (OS) hand (H)
The arrow/black shading shows the area of a Colles Fracture
Other causes of fractures
Fortunately, not every fall causes us to fracture. A broken bone is more expected when we fall from a height such as off a ladder or down stairs. Conditions such as osteoporosis, make bones easier to break. While Osteoporosis is thought to only affect older people it can also be present in younger adults. If you fall from a standing height and break a bone your Family Physician should consider whether to order a Bone Density Test to check the quality of your bone structure and discuss treatment options.
Is it a fracture or just a sprain?
Right after the fall you may wonder if you have a broken bone or just a sprain. Initially, if you have broken a bone, there is usually significant pain around the wrist, swelling and unwillingness to move the hand or wrist. If the bones are displaced, when you look at the forearm from the side, the alignment of the bones looks like a dinner fork. The presence of a ” dinner fork deformity” is a tell-tale sign of a Colles fracture. If you experience the above an urgent medical assessment is necessary. If the bone is broken an X-Ray confirms the break.
Medical Treatment; What to expect
A physician or Orthopaedic Specialist in the Emergency Room at the hospital will examine your wrist and look at the X-Rays to decide the best course of action. Most breaks are treated with a rigid cast for six weeks. The cast holds the bone in the correct position while healing occurs. While you are in the cast you will usually be allowed to move your fingers, thumb, elbow and shoulder to reduce the risk of stiffness.
A follow up X-ray is typically scheduled to check that healing is progressing. Once healing is confirmed, a referral to Physiotherapy is highly recommended for assessment of your hand and wrist flexibility and strength. A specific treatment plan can then be made to help you regain function as soon as possible.
How long will it take to recover?
The question I am often asked is “How long will it be before I’m back to normal?” Everyone is different and during your first few treatment sessions progress is measured to see if you are “on track” and improving. My experience with these injuries is that most people are recovered by about six months.
I find the best recovery is when you individualize treatment to ensure we have the best plan for you to regain joint flexibility, strength and function as quickly and safely as possible. In my next article I will outline what to expect from therapy.
If you have injured your wrist you can book an appointment to see me while you are in the cast or right after the cast comes off. Call us at 416-925-4687 to book an appointment or contact Gareth Sneath, Registered Physiotherapist, MScCH MCPA Grad Dip Man by email at firstname.lastname@example.org