Devon Hand Surgery

 

Jump to:                 What is Hand and Wrist trauma

                                  Common types of hand and wrist trauma

                                  Treatment options

                                  Recovery 

                                  Scaphoid fractures

                                  Scapholunate ligament injury 

                                  Distal radius fracture

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Introduction

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Injuries to the hand and wrist are common and can range from mild sprains to complex fractures or tendon injuries. The hand and wrist are vital for everyday activities, and even small injuries can significantly impact function. Early diagnosis and appropriate treatment are essential to ensure optimal recovery.

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What Is Hand and Wrist Trauma?

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Hand and wrist trauma refers to any injury caused by an external force. This may include accidents at home or work, sports injuries, falls, or direct blows. These injuries can involve bones, joints, ligaments, tendons, nerves, and skin.

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Common Types of Hand and Wrist Injuries

 

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Fractures (Broken Bones)

 

• Common fracture sites:

  • Distal radius (wrist)

  • Scaphoid (a small wrist bone)

  • Metacarpals (hand bones)

  • Phalanges (finger bones)

• Symptoms: Pain, swelling, bruising, deformity, or difficulty moving the hand or wrist.

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Dislocations

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• Occur when bones are forced out of their normal position (e.g., finger joint dislocation).

• Often accompanied by ligament damage.

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Soft Tissue Injuries

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• Ligament Sprains or Tears: Caused by overstretching (e.g., wrist sprain).

• Tendon Injuries: May involve lacerations or ruptures (e.g., flexor or extensor tendon injuries).

• Nerve Injuries: Can result from cuts, crush injuries, or traction.

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Open Injuries (Lacerations or Crush Injuries)

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• May involve skin, tendons, nerves, or blood vessels.

• Require urgent assessment to avoid infection or long-term damage.

 

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Signs and Symptoms of Trauma

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Seek medical attention if you experience:

 

• Immediate pain or swelling

• Bruising or deformity

• Inability to move fingers or wrist

• Tingling, numbness, or weakness

• Open wounds or exposed bone/tendon

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Diagnosis: What to Expect

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Your doctor or hand specialist will perform:

 

• Physical examination: To assess movement, strength, circulation, and sensation.

• Imaging tests:

  • X-rays: To check for fractures or dislocations

  • Ultrasound or MRI: To assess soft tissue injuries

  • CT scans: For detailed views of complex fractures

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Treatment Options

 

Non-Surgical Treatment

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Suitable for minor fractures, sprains, and tendon injuries without rupture:

 

• Splints or casts to immobilise the hand or wrist

• Pain relief and anti-inflammatory medication

• Rest, ice, elevation

• Hand therapy to restore movement and strength

 

Surgical Treatment

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May be necessary for:

 

• Displaced fractures

• Joint dislocations that can’t be reduced manually

• Tendon or nerve injuries

• Complex or open injuries

 

Surgery may involve:

 

• Bone fixation with wires, plates, or screws

• Tendon or nerve repair

• Joint stabilisation or ligament reconstruction

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Recovery and Rehabilitation

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Recovery depends on the type and severity of the injury. Your rehabilitation may include:

 

• Hand therapy: To regain movement, strength, and function

• Splinting: Custom-made splints for support or to encourage proper healing

• Gradual return to activity: Your therapist will guide safe progression

• Pain and scar management

 

Typical Recovery Times:

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• Minor sprains: 2–4 weeks

• Simple fractures: 4–6 weeks

• Tendon or nerve repairs: 8–12+ weeks

• Complex injuries: May take several months for full recovery

 

When to Seek Urgent Help

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Contact your healthcare provider or visit A&E if:

 

• There is a visible deformity

• You cannot move part of your hand or wrist

• There is numbness, tingling, or loss of circulation

• You have an open wound or signs of infection (fever, redness, pus)

 

Preventing Hand and Wrist Injuries

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• Use protective gear during sports or heavy work

• Avoid repetitive strain or unsafe lifting techniques

• Maintain hand strength and flexibility with regular stretching

• Treat minor injuries early to avoid complications

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Common injuries

 

Scaphoid Fracture and Scapholunate Ligament Injury

 

Injuries to the scaphoid bone and the scapholunate ligament are among the most commonly missed wrist problems. They can lead to long-term pain, stiffness, and arthritis if not treated promptly and properly.

 

Scaphoid Fracture

The scaphoid is one of the small carpal bones in your wrist, located near the base of the thumb. It plays a critical role in wrist stability and motion. Due to its unique blood supply, scaphoid injuries can be slow to heal and may sometimes require surgery.

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Causes

- Fall onto an outstretched hand (FOOSH)
- Common in athletes or accidental falls

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Symptoms

- Pain and tenderness at the base of the thumb
- Swelling and difficulty gripping
- Mild symptoms may delay diagnosis

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Diagnosis

- X-rays, MRI, or CT scans may be needed for clear diagnosis

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Treatment

Non-surgical: casting or splinting for stable fractures
Surgical: internal fixation with screws for displaced or non-healing fractures.

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Recovery Time

6–12 weeks in a cast, or longer with surgery and therapy

[Diagram Placeholder: Scaphoid Fracture Anatomy]

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Scapholunate Ligament Injury

The scapholunate ligament connects the scaphoid and lunate bones. It stabilises their movement during wrist motion. A tear or rupture can lead to wrist instability and long-term arthritis.

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Symptoms

- Pain and clicking on the back of the wrist
- Weak grip
- Worsens with loading the wrist

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Diagnosis

- Watson’s test, X-rays, MRI, or arthroscopy

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Treatment

Non-surgical: splinting, physiotherapy
Surgical: ligament repair or reconstruction for more severe cases

 

Recovery Time

6 weeks to 6 months, depending on severity and treatment

[Diagram Placeholder: Scapholunate Ligament Anatomy and Injury]

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Understanding Distal Radius Fractures

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A distal radius fracture is a break near the wrist end of the radius, one of the two long bones in the forearm. It is one of the most common types of fractures, especially after a fall. Prompt treatment helps ensure proper healing and restores full use of the wrist.

 

What Is the Distal Radius?

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The radius is the larger of the two forearm bones (the other is the ulna). The distal radius refers to the end of the bone near the wrist joint. A fracture here affects wrist motion, strength, and alignment.

 

What Causes a Distal Radius Fracture?

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Most commonly caused by:

 

• Falling onto an outstretched hand (FOOSH injury)

• Sports injuries or cycling accidents

• Osteoporosis-related falls (more common in older adults)

• High-energy trauma (car or motorbike accidents in younger patients)

 

Signs and Symptoms

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• Immediate pain and swelling around the wrist

• Deformity – wrist may look crooked or shortened

• Bruising and tenderness

• Limited movement or inability to use the hand/wrist

 

How Is It Diagnosed?

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• Physical examination to assess tenderness, deformity, and circulation

• X-rays to evaluate the type and position of the fracture

• CT scans may be needed for complex or joint-involving fractures

 

Treatment Options

 

Non-Surgical (Conservative Management)

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Appropriate for:

• Non-displaced or minimally displaced fractures

• Stable fracture patterns

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Treatment includes:

 

• Plaster cast or splint for 4–6 weeks

• Pain relief and swelling control

• Follow-up X-rays to monitor healing and alignment

 

Surgical Treatment

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Recommended for:

• Displaced or unstable fractures

• Intra-articular (joint-involving) fractures

• Open fractures (broken skin)

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Common surgical options:

 

• Open Reduction and Internal Fixation (ORIF) – using a metal plate and screws

• External fixation – for severe or open injuries

• Percutaneous pinning – less invasive option in some fracture types

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