Hand Surgeon, Orthopaedic Surgeon
Dear Jacinta
The initial treatment for most fractures is to be splinted in an incomplete plaster cast. This will provide pain relief by immobilising the fracture. A complete, circumferential cast will sometimes become too tight as the area swells in response to the trauma.
Definitive treatment can be either a full cast or surgery. The best person to determine which is the treatment suited for you will a wrist surgeon. The decision will depend upon many variables. These include the fracture pattern, fracture stability, your general health, your activities, and your upcoming holiday.
Most wrist fractures treated without surgery will be immobilised for a total of around 6 weeks. A full cast can be applied by a hand therapist or physiotherapist once the initial swelling has subsided. This is usually 1 to 2 weeks after the injury. A waterproof synthetic cast is much lighter and more convenient than a plaster cast. A plaster cast will mold a bit better and will cost less.
Surgery can mean not needing a plaster at all. It will involve straightening the fracture and inserting a plate with screws to hold the fracture in position whilst it heals. The duration of splinting after surgery is dependent on fracture stability and surgeon preference. I usually splint for 7 to 10 days and then leave the wrist unsplinted. Range of motion exercises start at that time. Strengthening exercises start at 4 weeks.
There are risk associated with both non-operative and surgical treatments.
This advice is general in nature. You should discuss your options with your GP and/or a wrist surgeon.
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