The 2 Most Common Hand and Wrist Injuries
What are the 2 most Common Hand and Wrist Injuries?
Two of the most common wrist and hand diagnoses seen in Orthopedic clinics are Carpal Tunnel Syndrome (CTS) and Distal Radius Fractures. These diagnoses can occasionally occur together as a result of a fall. Carpal Tunnel Syndrome generally occurs from the insidious onset with numbness, which wakes you up at night, decreased sensation in hand, weakness, and pain, and occasionally occurs from trauma.
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. An X-ray is required to diagnose this fracture. Most wrist fractures are 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. During this time, it is important to move your fingers while cast and keep your arm elevated as needed to prevent stiffness and swelling. Therapy may be recommended once the cast is removed to restore the wrist and hand’s functional mobility.
If the fracture is displaced at the time of injury or has shifted as seen on a follow-up X-ray, the orthopedic doctor may recommend 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 will be placed into the radius. This holds the fractured pieces together and restores the anatomy of the wrist. After surgery, the patient will be placed in a splint (vice a cast) at a post-op follow-up appointment.
Therapy is recommended for the following reasons:
- 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. At the time of ORIF surgery to repair the fracture, a Carpal Tunnel Release is performed.
Injuries in the Clinic
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 open Carpal Tunnel Release surgery to be performed at the time of ORIF for the distal radius fracture or later pending clinical presentation.” Carpal Tunnel Surgery can be performed with an open incision at the base of the palm or endoscopic when this is the only diagnosis. Dr. McGinley stated, “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 is no longer impinged.”
Therapy is recommended by an Occupational Therapist or Physical Therapist who specializes in hand therapy. The goal of therapy is to improve functional use. This allows activities of daily living by restoring and improving wrist and hand mobility and strength.
All JOI Physicians and Therapists now offer Telehealth services for virtual visits from the convenience of your home.
- To schedule an appointment for physical or occupational therapy, call (904)858-7045 or call any of the 12 area JOI Rehab Centers.