BMJ Best Practice Podcast Wrist fracture
Feb 10, 2025
Michael Barrett, a Consultant Trauma and Orthopaedic Surgeon at Cambridge University Hospitals, shares his expertise on wrist fractures. He highlights the prevalence of these injuries in older women with osteoporosis and younger men after high-impact events. The discussion covers essential diagnostic techniques, particularly for distal radius and scaphoid fractures. Barrett underscores the importance of effective management and challenges, including pain relief strategies and the care of patients with comorbidities, making it clear that accurate diagnosis and follow-up care are crucial.
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Diagnosis of Wrist Fractures
- Diagnose wrist fractures with history, examination, and X-rays (two views minimum).
- Further tests like CT or MRI scans are sometimes needed for subtle fractures or carpal injuries.
Pitfalls in Diagnosing Scaphoid Fractures
- Missing a scaphoid fracture can have devastating consequences due to its poor blood supply.
- This can lead to non-union and arthritis later in life, especially in younger individuals.
Managing Wrist Fractures
- Start with pain relief following the WHO ladder.
- Undisplaced fractures require immobilization, preferably with removable splints, while displaced fractures need reduction and manipulation.