Conditions & Treatments

Fractures

Facts about Elbow, Hand, and

Wrist Fractures

Arora Hand Surgery in Warren, Howell, Macomb Township, and West Bloomfield treats elbow, hand, and wrist fractures with expertise and compassion. Arm fractures are painful and will take time to heal, but recovery is possible with the best local hand surgeon by your side.

Elbow

Fractures

Elbow fractures can occur from a fall, a direct impact from athletic activities, a twisting injury, and more. The three bones in the elbow that could be affected are the: humerus, radius and ulna.

ELBOW FRACTURE SIGNS AND SYMPTOMS
Light to extreme pain, bruising, and stiffness around the elbow could mean that you have a fracture. Did you hear or feel a pop at the time of the injury? Was the skin broken during impact? Do you see a deformity or dislocation of the elbow joint? These are all questions we’d ask, and we’d be sure to check for nerve or artery damage.

DIAGNOSIS & TREATMENT
X-rays are a great way to confirm an elbow fracture and to determine if the bones are displaced.

A CT scan might be needed in order to obtain further detail of the joint.
One area of concern after a fracture is long term stiffness in the elbow, so we want to maximize early motion and will give you the tools on how to do so. An interesting fact about casts is that they’re more frequent in kids due to their lower risk of developing stiffness.

When it comes to surgery, fractures that are displaced are more likely to need it in order to stabilize the fragments, remove any bone fragments, and allow for early motion. Another reason for surgery is when the skin is broken above the fracture. There’s an immediate need to clean out the bone to minimize the risk of infection.

Therapy is often times needed to encourage more motion. The Arora Hand Surgery will teach you exercises you can do at home, provide you with scar massages, recommend specific splints, and administer modalities such as heat, ice, etc. to further progress your recovery.

TYPES OF ELBOW FRACTURES

Radial head and neck fractures

In these factures, you’ll notice that your pain may feel worse with forearm rotations. It’s important for your healthcare provider to detect the presence of a mechanical blockage of motion (from fracture fragments) as early as possible. The treatment options depends on a few things, such as the number of fractures and size of their displaced fragments. Fractures without displaced fragments are treated with early motion. More complex fractures may need surgery to repair the fragments or to replace the radial head.

Olecranon fractures

Stable fractures can be initially treated with splints, followed by hand therapy exercises that will increase your range of movement. Severely displaced or unstable fractures may need elbow surgery. In elbow surgery, the bone fragments are aligned perfectly and held together with pins, plates, and/or screws.

Fractures of the distal humerus

Distal humerus fractures usually occur in kids and seniors. Nerve or artery injuries can be associated with these types of fractures and must be evaluated. These fractures usually need surgery, except for those that are minimally or non-displaced, stable, and have no associated nerve or artery injury.

Wrist

Fractures

The wrist is made up of eight small bones and the two forearm bones, the radius and ulna. The bones allow the wrist to bend and straighten, move side-to-side, and rotate in a way that allows the palm to face up or down.

A fracture in these bones can occur when enough force is applied to injure them, such as falling down onto an outstretched hand. Severe injuries are possible from more forceful injuries, like car accidents or a fall from a higher distance such as a ladder. Many people think that a fracture is different from a break, but did you know that they are the same?
Bone conditions such as osteoporosis, may also make someone more susceptible to getting a wrist fracture.

When the wrist is broken, there is light to severe pain, swelling, and a decreased mobility of the hand and wrist. You’ll notice that the wrist can appear deformed, and that could be because the bone fragments have shifted beneath your skin. Fractures of the small wrist bones, such as the scaphoid, are unlikely to appear deformed.

Some fractures, if severe enough, may break the surface; others will be near the joint but leave the joint surface intact. Sometimes the bone is shattered into many pieces, which usually makes it unstable.

An open or “compound” fracture occurs when a bone fragment breaks through the skin. There is some risk of infection with compound fractures, so it is important to see a medical professional immediately.

The most broken wrist bone is the radius due to its delicacy.

EXAMINATION & TREATMENT

An examination and X-rays are required in order to determine if there is in fact a fracture. If there is, a treatment plan specific to the patient’s needs is created next. In some cases, a CT scan or MRI is administered when there is a need to garner more detail about the fracture.

We may also find that ligaments, tendons, muscles, and/or nerves become injured during a wrist accident. These injuries may need to be treated along with the fracture.

To determine your treatment, we consider a few factors: the pattern of the fracture, if it is displaced or non-displaced, or if it’s stable or unstable. Other important considerations include your general health, age, hand dominance, work, hobbies, prior injuries, and history of arthritis.

A splint or cast can be used to treat a non-displaced fracture or to carefully protect a fracture that has already been set. It’s important to note that other fractures may require surgery so that the bone is stabilized and set correctly.

Some ways to stabilize a fracture is by using pins, wires, screws, plates, rods, and external fixations. External fixation is a method in which a frame outside of the body is attached to pins which have been placed into the bone above and below the fracture site. This allows the fracture to stay in traction until the bone heals.

Sometimes, arthroscopy is used in the evaluation and treatment of wrist fractures.

In severe accidents, bone may become missing or may be so crushed that there’s a bone gap once the fracture has been re-aligned. In cases like this, a bone graft may become necessary. In a bone graft, bone is removed from a different part of the body to help fill in the missing area. Other options instead of this include using bone from a bone bank or using synthetic bone graft substitutes.

RECOVERY & PROGNOSIS

While your wrist fracture is in the healing process, it’s vital to keep the fingers moving and flexible – as long as there are no additional injuries that require your fingers to be immobilized. Otherwise, there is a risk of finger stiffness, which may compromise your hand’s future function and recovery. If the wrist has enough stability, motion exercises may be started for the wrist itself. Your hand surgeon, Dr. Arora, and hand therapist will work together to determine the appropriate timing for exercises that will recover your strength and function.

Recovery times vary and depend on the severity of the injury and other factors that have been noted above. It’s common for total wrist facture recovery to take several months. Some patients may have residual stiffness or phantom aching. If the surface of the joint was severely injured, arthritis may develop in the long-term future. Sometimes, additional treatment or reconstructive surgery may be required.

Hand

Fractures

Hand fractures can be the result of a variety of accidents and impact numerous parts of the hand, from the smaller bones in the fingers to the longer ones. A hand fracture can be caused by a fall, direct contact in physical activity, and a twisting or crushing injury, along with many other possibilities.

Two of the most common types of hand fractures are phalanges fractures and metacarpal fractures.

Phalanges fractures occur in the fourteen smaller bones of the fingers. The thumb contains two phalanges, while the other fingers contain three each.

Metacarpal fractures are a break in one or more of the five long metacarpal bones of the fingers.

Signs of a Hand Fracture

Because they are often associated with an injury and can be painful, hand fractures typically require urgent or emergency care. Signs of a hand fracture include:

  • Deformity
  • Swelling
  • Inability to move
  • Tenderness
  • Shortened finger
  • One finger crossing over another when trying to form a fist
Examination & Treatment

Dr. Arora can examine and assess the fingers as well as the condition of the skin to better determine if you are experiencing a hand fracture.

Dr. Arora may test the motion and sensitivity in the fingers. A check of finger motion allows Dr. Arora to determine if there is any significant loss of finger length or loss of the normal alignment of the fingers. Testing the sensitivity to touch in the finger helps determine whether there is nerve damage within the hand. An X-ray is also taken to closely assess the extent and location of the fracture.

The location and extent of the fracture will determine the course of treatment.

One common method for treating a hand fracture is by wearing a splint or brace. Splints are used to cover and protect part of the fingers in addition to both sides of the hand and wrist. How long you may need to wear the splint will also depend upon the extent of the fracture.

Another possible treatment option is surgery, based on accepted standards and the nature of your fracture. Dr. Arora will help determine what is right for your fracture and take into consideration your individual situation and needs.

You may require surgery if:

  • Your metacarpal bones are broken and misaligned
  • Your fingers do not align correctly
  • The fracture has broken through the skin
  • The pain gradually worsens
Recovery & Future Appointments

Dr. Arora will provide you with aftercare instructions that we strongly recommend following to promote optimal healing. Should a splint be necessary, we advise you not to remove it until instructed to do so.

Medication may be prescribed to you to help alleviate sensations of pain and discomfort. Patients should keep their affected hand elevated as much as possible to help reduce swelling and discomfort. All patients who undergo hand fracture treatment will make follow-up appointments so that Dr. Arora can monitor your recovery.

If you are experiencing any signs or symptoms of an elbow, wrist, or hand fracture, contact us to schedule an appointment with our hand surgeon in West Bloomfield, Howell, Macomb, or Warren.

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.