Compound Fracture of Wrist: Causes, Symptoms, Treatment, Recovery, Physiotherapy
What is Compound Fracture of Wrist?
Compound Fracture of the Wrist is a type of fracture which is usually caused due to a traumatic injury because of which the wrist bone breaks in such a way that it juts out of the skin. For example, if a pedestrian is struck by a moving car on the foot then the bone may penetrate through the wound caused by the injury and can be seen through the naked eye.
Now coming to what is Compound Fracture of the Wrist, it is important to understand the anatomy of the wrist. The wrist is made of different types of bones and joints. There are two main bones and eight small bones in the wrist with the two mains bones being the radius and the ulna. Compound Fracture of the Wrist usually occurs in these two main bones only.
Compound Fracture of the Wrist can occur due to any traumatic injury to the wrist like being hit by a jackhammer while working, or while working in the kitchen and something heavy and sharp falls on the wrist accidentally and breaks the wrist in such a way that the bones juts out through the wound and causes a Compound Fracture of the Wrist.
What Can Cause Compound Fracture of the Wrist?
As stated above, a traumatic injury is the root cause of a Compound fracture of the Wrist. This injury can be caused due to any accident like being crushed under a machine while working, something falling on the wrist which has a sharp edge and is heavy, getting injured while playing contact sports like football and rugby, high force twisting of the wrist can also be a cause of Compound fracture of the Wrist. A Compound fracture of the Wrist can be mild in which not much bone is visible and the wound may be just a few millimeters in diameter while there may be certain types of injuries in which a lot of the bone is visible due to the wound being deep and wide. As the bones in Compound fracture of the Wrist become exposed there is also a risk of contamination and infection due to environmental bacteria and other irritants.
What are the Symptoms of Compound Fracture of the Wrist?
The first sign of a Compound Fracture of the Wrist is that the wrist bone will be visible eye through the wound. This will be accompanied by swelling of the injured wrist. The individual will find it extremely painful and difficult to move the wrist in any direction. There will be visible deformity of the wrist due to the Compound Fracture of the Wrist. The patient will also find it difficult to pick something up from the affected hand.
What is the Treatment for Compound Fracture of the Wrist?
It is extremely important for any Compound Fracture to be treated as soon as possible as the area that is open may get infected by environmental allergens and the same goes for Compound Fracture of the Wrist. If the wrist wound gets infected then it can delay the healing process of the compound fracture of the wrist and may even lead in some cases to amputation of the wrist.
As soon as the patient is taken to the emergency room, he or she will be given a tetanus shot and started on antibiotics. Depending on the severity of the disease the type of antibiotic used will be given. The next step towards arriving to a treatment plan will be to take imaging studies of the affected wrist. This is done by taking x-rays or MRI scan of the wrist to look at the internal structures and to look at the extent of damage to the tissues and bones.
The next step will be to stabilize the patient and cover the wound with a sterile dressing. The physician will try to gently put the bones back into alignment as much as possible to prevent the fragments from causing further damage to the tissues. A wrist splint will be placed for immobilization to prevent further displacement of the fracture.
Once these treatment protocols are done, then comes the real part of treating Compound Fracture of the Wrist. To control the infection, the physician will first do and I&D or what is called as irrigation and debridement. During this procedure, the surgeon will remove all the dirt and foreign material from the wound along with any unhealthy skin or soft tissues. The surgeon will also clean the bones off of all dirt and foreign material. Any free fragments of the bones will be removed. This loss of bone due to removal can be corrected later with further surgical procedures. Once debridement is through then the wound is cleaned with normal saline.
After these things are done, the treatment for compound fracture of the wrist starts. It is important here to note that it is extremely vital to stabilize the fractured bones to prevent further damage to the tissues. Next, the patient is prepared for surgery for fixation of the compound fracture of the wrist. The fracture may be fixed either internally or externally. Internal fixation is done for minor Compound Fracture of the Wrist which has minimal contamination and less severe injuries. External fixation is reserved for severe Compound Fracture of the Wrist with greater risk of contamination and injuries.
Internal Fixation of Compound Fracture of Wrist: In this procedure, the wrist bone fragments are first realigned in their normal position and then held together with screws and plates on the outer surface of the bone. This method of fixing the fracture aligns the bone almost in its normal fashion. It is to be noted here that since there may be significant tissue damage and other injuries in a Compound Fracture of the Wrist, it may take some time before a surgery to fix the fracture is done.
External Fixation of Compound Fracture of Wrist: In this procedure, the bone is realigned in its normal anatomical position and screws and plates are fixed above and below the fracture site. These screws are then connected to metal bars placed outside of the skin.
Once the compound fracture of wrist is fixed, then the wound needs to be closed. Wound closure is done depending on the complexity of the wound. These can be done through local flap or free flap procedures. In local flap procedure the muscle tissue of the injured wrist is rotated so as to cover the fracture and then a skin graft is placed over this. In Free Flap procedure a complete transfer of tissue is done. The tissue is usually taken from the back of the abdomen.
Once you are through with the surgery, in the postsurgical period you will more often than not have pain for which you will need pain medications in the form NSAIDs like Tylenol or ibuprofen for pain relief.
What are the Complications of Compound Fracture of the Wrist?
Some of the complications of Compound Fracture of the Wrist are:
Infection: This is by far the most common complication as in compound fracture the internal structures are exposed to environment and hence there are higher chances of infection.
Difficulty Healing: Some Compound Fracture of the Wrist may even fail to heal or may be slow to heal or you may not achieve the exact result even with surgery which may require further need for surgical procedure to fix it and promote healing.
What is the Recovery Time from Compound Fracture of the Wrist?
The time it will take to recover completely from the injury depends on the severity and complexity of the injury. It is not uncommon to have postsurgical stiffness, pain, and weakness which may persist for months after the injury and surgery. You also need to do the exercises during the recovery phase as advised by the physician diligently for a speedy recovery from Compound Fracture of the Wrist. Normally it takes around 8-12 weeks for the fracture to heal and once the wound is completely healed and you are able to move your wrist then you can gradually return to normal activities but it takes at least 15 weeks before you can go back to your daily routine after suffering from a Compound Fracture of the Wrist.
How Can Physiotherapy Help With Recovery from Compound Fractures of the Wrist?
Physiotherapy also has a great role to play to make the joint movements easy that can help the wrist to become normal sooner. There are numerous techniques used under physiotherapy that can help the patient. It includes normal wrist exercises, ultrasound therapy, cold therapy, infrared or heat therapy and massage therapy. All these treatments must be taken under the guidance of an expert physiotherapist only. There are numerous benefits offered by all these treatments which include enhancement of muscle stretching, augment coordination, improvement in movements of joints and maintain normal muscle tone. One can be provided treatment by an expert physiotherapist manually as well as with the help of different devices.
The manual exercises include opening and closing of hands as well as moving the wrist clockwise and anticlockwise. With the passage of time the faster movement helps the muscles to gain the prior stage of flexibility, which makes the patient recover fully from the fracture. There are also machines with vibrator and momentum that can help the patient to match the frequency with the machine and recover quickly and easily from compound fracture of the wrist.
Home Remedies to Help Compound Fracture of the Wrist Heal Faster Following Surgery
Castor Oil: Castor oil is much known for its quality to cure various ailments. One can use Castor oil in case of a wrist fracture also. It is an easily available home remedy that can have tremendous effects and help faster recovery. It has anti-inflammatory properties that can help to heal the joint and strengthen the bones. One can have castor oil availed from a medical store or a general store. Just dip a cotton ball in the castor oil and apply it to the fractured bone. Fix it there with a tape and leave it for a night or two. It will help the bone fix faster and relieve pain as well as inflammation. Regular application of castor oil can improve the bone health faster.
Black Caraway Seeds or Kalonji: These tiny black seeds also can do wonder to heal the bone fracture. These seeds have zinc, phosphorus and iron contents which are highly useful to recover the bones from displacement as well as fracture. One just needs to take Black Caraway Seed oil and apply it gently on the affected area. Just massage it for 10-12 days and see the results. It can control the swelling and pain faster and at the same time one can also check the easier movement of the wrist.
Turmeric: Turmeric has excellent qualities that can offer wonderful health benefits which include bones as well. It has antibiotic as well as anti-inflammatory qualities that can help the bone to heal the fracture faster. One can drink milk with added turmeric as well as make a paste of turmeric with onion and a little salt. Apply the paste to the affected area and cover it with a band. In a few days, the fracture can get healed. One can also take some turmeric powder and warm water to form the paste and apply the paste on the injured area to cure the hairline fracture also. In case there is also wound one can simply use turmeric powder and stop bleeding immediately. It is also antibacterial and hence one does not need to fear about any infection.
Ice Pack: Perfect application of Ice pack on the affected area can also help joint as well as bones. One just needs to apply the ice pack to the fractured bone for 5-10 minutes and for 5-6 times a day. It can also help to relieve pain, remove inflammation and get quicker recovery. There are different ice packs available in the market, and hence, one can use them as an urgent option to recover from pain and swelling.