Wrist Fractures

Some of the most miserable patients I see have had their wrist fractures fixed by non-specialists who think that distal radius fractures are all simple ‘colles’ fractures that ‘all do great’. Unfortunately, this is far from the truth. Distal radius (wrist) fractures are probably the most treacherous fracture in the entire arm. Many patients tell me that their surgeon bragged to them that it only ‘took 20 minutes’ to put a couple of pins in to the bone to fix it. The problem is, once those pins are pulled, the fracture often collapses back to where it was before the pins were placed, ie. an unacceptable position.

Worse, when the wrist is in bad position it makes it difficult to use the hand. As the wrist is the foundation of the hand, if the wrist is in poor position, then the fingers can get stiff. And now the patient is looking at multiple surgeries to get back to where he/she could have been had they just had a specialist fix their wrist in the first place. The first surgery is to correct the wrist. If the fingers are stiff, then there’s another surgery or two to release the joints to get them moving again. And a ton of hand therapy in between, which is time-consuming, somewhat unpleasant (ie. it can hurt) and expensive.

It’s really tough to know what doctor to go to for your problems. Even I have to ask around a bunch to find out which specialist to see for a non-orthopaedic medical problem that myself or one of my family is having. For wrist or hand fractures it’s pretty easy. Go to ASSH.org and click on the ‘find a hand surgeon’ section for your city. There are no guarantees, but if he/she’s a member of the ASSH you know he’s a fellowship-trained hand surgeon with a certificate of additional qualifications (CAQ), and he/she’s probably pretty up to date on how to treat these. More important, a hand surgeon has a vast experience treating both simple and complex hand & wrist fractures, and will know what to do if any problems arise along the way. In Houston, I have many patients who had to learn to seek specialty care the hard way. Remember: just because a surgeon did OK with your knee, that doesn’t mean that they’re great with every single part of the body. That’s like having a plumber rewire your home’s electrical system because he did a great job on your faucet; not such a great idea. It’s a lot better and more convenient to travel a couple of extra highway exits to see a specialist and have one surgery that turns out well, then to save 10 minutes of travel and spend the next year in a doctor’s waiting room, in surgery and in therapy trying to salvage an initial operation that didn’t turn out the way you would have liked.

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