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What Happens Surgery for a Wrist Fracture?

Clip Number: 8 of 33
Presentation: Distal Radius Fracture Surgery
The following reviewers and/or references were utilized in the creation of this video:
Reviewed By: Arthur Schoenstadt, MD
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After the anesthesia has taken effect, a tourniquet or blood pressure cuff will be placed on your arm to temporarily stop the blood flow to your hand and wrist. However, if your doctor doesn't need to make an incision, the tourniquet won't be used.
To help reduce the chance of infection, the affected area will be scrubbed with a special solution, and you will be covered with sterile sheets. The only area exposed will be your lower arm.
Your doctor will first locate the broken, or fractured, area of your wrist. This is done with a special x-ray machine. Once the fractured area is found, the bones will be lined up in their proper position.
Your doctor may be able to improve the positions of some of the bone fragments by manipulating your wrist, arm, or hand. Or, if necessary, your doctor can make an incision over the fracture to make it easier to move the bone fragments. X-rays are then usually taken to make sure that the bones are lined up. Once properly aligned, the broken ends of the bones must be stabilized so they can heal. There are many ways to do this.
Sometimes, after the fractured bones are aligned in the operating room, only a cast is needed to hold them in place well enough to allow healing.
But, your surgeon may decide metal implants are necessary to stabilize the fracture. Such implants include:
• A metal plate with screws,
• Screws without a plate,
• Wires,
• Pins,
• A device called an "external fixator,"
• Or a combination of these.
A metal plate is a special piece of metal that has holes in it. An incision must be made to place a plate over a fracture. Once the fracture has been aligned, the plate is positioned on the bone with screws to help hold the fracture in the correct position. Not all of the holes in the plate may be filled with screws. Your surgeon will determine which ones are important for your particular case. If a metal plate is used, in most cases it will stay inside your body for the rest of your life. However, if it causes problems, it may be removed after the fracture has healed.
Pins or wires are also used to fix fractures. They are usually quite small, and may be inserted through your skin without making an incision. The x-ray machine is used to help guide them into place. Most of the time, the ends of the pins are left outside the skin to make it easier to remove them. The pins are usually left in place for about 6 weeks.
An external fixator is a device used to stabilize fractures from the outside of the skin. To place an external fixator, pins must first be inserted into the bone from the outside of the skin. Small incisions are necessary for this. Usually, two pins are placed in the radius and two are placed in a small bone in the hand. These pins are then connected to the metal frame of the external fixator. The fixator and the pins are removed after the fracture has healed.
The way that your doctor treats YOUR wrist fracture will depend on several factors, including the location, type, and severity of the fracture. Before the surgery, your doctor should determine which method will be the best for your situation. But, at some point during the surgery, your surgeon may decide to use a different type of metal hardware than what was originally planned.
Once the hardware is placed and secured, a sterile bandage and a splint will then be applied. The splint will cover your hand, wrist, and forearm; occasionally a splint or cast that covers the whole arm is needed. The splint is used to hold the wrist in place, protect the incision -- if one was needed -- and promote healing.
 

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