The 2 Most Common Hand & Wrist Injuries

By Dr. Scott McGinley

What are the 2 Most Common Hand and Wrist Injuries? 

The 2 hand and wrist injuries are common in Orthopedic clinics are Carpal Tunnel Syndrome (CTS) and Distal Radius Fractures.

woman wincing in pain holding hand and wrist

Carpal tunnel syndrome is one of the 2 most common hand and wrist injuries

The most common wrist fracture from falling on an outstretched arm is a Distal Radius Fracture. Symptoms that require medical attention include swelling, pain, bruising, tenderness, numbness, hand weakness, and hanging of the wrist. Your doctor will prescribe an X-ray to diagnose this fracture. A wrist fracture will require a cast for approximately 6 weeks. Your doctor will follow your recovery. Additional x-rays may be required to ensure the fracture is healing with good alignment and has not shifted. It is important to keep your arm elevated as needed to prevent stiffness and swelling. Physical therapy begins after cast removal. This will help to restore the wrist and hand’s functional mobility.

illustration of carpal tunnel

Carpal tunnel syndrome one of the most common injuries to the hand.

Surgery Options

A fracture with displacement may require surgery. This is to restore anatomy to improve the wrist’s mobility and prevent arthritic changes in the future. The surgery is called ORIF, which means Open Reduction Internal Fixation. A plate and screws secure the reduction into the radius. This holds the fracture or pieces of bone together and restores the anatomy of the wrist. After surgery, the patient needs a splint (vice a cast) at a post-op follow-up appointment.

Physical therapy helps:

  • Reducing edema.
  • Scar management.
  • Restoring functional use of the hand for grasp and pinch and gentle wrist motion.

The fracture will heal in approximately 6 weeks. Occasionally, the patient will present with extreme numbness of fingers due to a compression of the median nerve from distal radius fracture.  During the ORIF surgery, a Carpal Tunnel Release is done.

The 2 most common hand and wrist injuries treated by JOI

Recently Terri Ahern OTR/L, Occupational Therapist for Jacksonville Orthopaedic, had the opportunity to consult Dr. Scott McGinley about the 2 most common hand and wrist injuries that he sees in his practice at JOI Clay/Fleming Island. Dr. McGinley stated, “a majority of Distal Radius Fractures require casting or bracing to immobilize the fracture depending on the type of fractures seen on X-ray. Approximately 10% of fractures will require surgery. Occasionally a patient will present with Carpal Tunnel Syndrome at the time of the initial visit or during the fracture healing time frame.” He estimates this happens approximately 25% of the time in his practice.

Carpal Tunnel Release

Many times patients have had a prior history of Carpal injuries, and the injury increased the symptoms. This will require an open Carpal Tunnel Release surgery at the time of ORIF for the distal radius fracture or later pending clinical presentation.  Carpal Tunnel Surgery is an open incision at the base of the palm or endoscopic when this is the only diagnosis. Dr. McGinley states, “he prefers to perform Open Carpal Tunnel Release from his training because at the time of the surgery he can perform the release and check the status of the nerves and tendons running through the carpal canal and also releasing the fascia to ensure the median nerve no longer impinges.”

The goal of occupational therapy is to improve functional use. Therefore, this allows activities of daily living by restoring and improving wrist and hand mobility and strength.

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