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Wrist fractures
Wrist fracture is the most common type of fracture before the age of 75. In women, the number of wrist fractures increases at menopause and plateaus after age 65. This increased incidence is most likely related to the rapid loss of bone in the years following menopause.
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The wrist is made up of two bones in the lower arm, the radius and ulna, plus the small bones of the hand. The most common wrist fracture occurs when a person extends an arm to break a fall. The hand and forearm take all the weight and force from the fall, and one or both of the lower arm bones breaks. When the radius breaks within 1 or 2 inches of the wrist (the distal radius), the fracture is called a Colles fracture, named after the doctor who first described it. Colles fractures occur most frequently in post-menopausal women. Usually, an X-ray can confirm the diagnosis. Once the fracture is diagnosed, appropriate treatment begins.
The appropriate treatment depends on the location and severity of the fracture. A simple fracture means that the bone has broken, but the broken edges remain close enough together that simple manipulation realigns the involved bone (known as reduction of the fracture). A more complex fracture means that multiple pieces of bone are broken or that the joint is involved. In this case, a cast alone may be inadequate and surgery may be required.
The first cast or splint may extend above the elbow to restrict movement of both the elbow and wrist. Your healthcare provider will teach you exercises for your fingers and shoulder on the affected side. It is important that you perform these exercises for short periods of time several times a day, even while in the cast. This will prevent finger stiffness later on, one of the side effects of the Colles fracture.
Over the first two to three weeks, your wrist may be X-rayed weekly. If the bones have slipped out of position, an operation may be needed to reposition the bones and fix them in place. In most cases, the cast or splint is removed after six or eight weeks. Both active and passive exercises for the hand, wrist, forearm, elbow, and shoulder will help you regain your strength and maintain mobility. After the cast or splint is removed, you may use a wrist splint or elastic wrap to support and protect the joint. Sometimes, the wrist may not look exactly the same as it did before the fracture, but with proper physical/occupational therapy, little function will be lost.
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