A broken wrist is known as a wrist fracture and it may occur due to a variety of causes starting from undue pressure on the wrist which can result in an injury as well as debilitating conditions like arthritis, which makes the bones and joints prone to fractures. There are also non displaced breaks, which are stable kinds of fractures and in which, the wrist remains in its place. Let us find out more about the kinds of fractures and the procedures for treatment of the same.

Type of Fracture: The wrist is basically made up of eight small bones that connect the two long arm bones, which are known as the radius and ulna and create the forearm. The broken wrist can take place in any of these bones. A hand surgeon will generally take a look at this kind of fracture and determine whether it is displaced, stable or open. As discussed earlier, a wrist fracture can be of various types. While a non displaced wrist fracture is a more stable kind that does not really require much more than rest or medication, a displaced wrist fracture is a non stable kind where dislocation happens.

Other Factors: There are a variety of other factors that will be taken into consideration in order to repair this kind of a fracture. To begin with, the Orthopaedic specialist will consider your age and the kind of job, hobbies and other kinds of activities that you indulge in. Also, the doctor will try to ascertain whether or not you are in good health on an overall basis. The presence of other injuries will also be taken into account for this kind of an injury in there has been a bike or car accident that has caused the fracture.

Treatment: The method of treatment will vary as per the considerations listed above. A padded splint may be installed in order to align and support the bones and wrist respectively, so that there is ample relief from the acute pain as well. Further, an unstable fracture will require a cast as to support the entire forearm and give proper rest to the region so that the bone can grow back together and get aligned again. Surgery may also be required for very severe cases, and pins, screws, metals and plates may also be used depending on the exact location and type of fracture.

Recovery: Remember to move your fingers as much as you can so as to prevent them from getting stiff while they are held up in a splint or a cast.
Hand therapy will be helpful in gaining back motion and function of the wrist.

Wrist Fracture Procedure - Facts You Should Know About 

Spinal fusion is a surgery in which two or more vertebrae in the vertebral column or back are fused or joined to treat a slew of spinal problems and diseases, which cause debilitating back pain. This surgery helps to remove bone and tissue that are narrowing the spinal canal, squeezing the spinal cord and nerves, reducing pain and improving function.

There are many different causes of back pain like injury, poor posture, age, osteoarthritis, herniation of disc between two vertebrae, degenerative disc disease, narrowing of spine called stenosis, and spondylosis or lessening of space between the vertebrae- most of these can be treated using spinal fusion.

All of these causes put tremendous pressure on the vertebrae and pinch spinal nerves that pass through the back and radiate out into the arms, legs and torso. Apart from the pain, patients experience nerve and muscle weakness and irreversible damage affecting normal life.

Spinal fusion started off as just a treatment for fractures but now it has become the surgery of choice for a number of spine problems. Though it can be done anywhere in the spine, it is very effective when done in the lower part of the spine called lumbar spinal fusion or arthrodesis.

Spinal fusion is done by forming a direct bony connection between the vertebrae surrounding the painful discs, the cushioning between the vertebrae. Pain is stopped by stopping the motion of the painful discs.

There are different methods of spinal fusion each with its own advantages and limitations.

Techniques include fusion approached from the front, the back, or both of the vertebral column. Sometimes surgeons decide to use intervertebral cages or metal screws to provide internal structural support while the bone fuses. These cages may be placed between the vertebrae and packed with bone graft material taken from the patient or constructed out of synthetic materials.

What to expect?
Spinal fusion is not a risk-free procedure. It is a major surgery lasting several hours and carrying a number of risks like-

Failure of the vertebral fusion and breaking of metal implants
The vertebrae above and below the fusion can wear away aggravating problems
Blood clots may be formed that can travel to lungs causing embolism
Injury to spinal nerves causing permanent weakness in legs and problem with bladder and bowel function
Infections and blood loss
Heart attack or stroke during surgery
The patient has to be kept in hospital for a couple of days for post-operative care after which he will have to undergo rehabilitation for months. Hence, one should really think before going for spinal fusion. And when it is recommended, seek a second opinion before making a decision. 

Spinal Fusion Surgery - What To Expect?

Spinal trauma, also referred to as spinal cord injury, occurs when a section of your spinal cord or the nerves at the edge of your spinal canal is damaged. The spinal cord acts as a messenger between the brain and other parts of your body. If the spine sustains an injury, all or some of these impulses may not get through. This may result in complete loss of mobility and sensation below the site of injury. An injury closer to the neck can cause paralysis throughout a larger part of the body than in the lower back region.

How do such injuries occur?

Often, spinal trauma or injury results from a violent event or an unpredictable accident. The following may severely damage your spinal cord-

  A violent attack (a gunshot or a stabbing)
  A motor vehicle accident that may cause trauma to the neck, back or head
  Falling from a great height
  Spinal or head injuries during some sports activity
  Electrical accidents

What are the signs of a spinal cord injury?

The followings signs and symptoms can be observed after an injury to the spinal cord-

  Difficulty walking
  Restricted movement of the legs and arms
  Stiffness, pressure and intense pain in the neck/back
  Loss of sensation
  Muscle spasms
  Loss of bowel or bladder control
  A twisted neck or back
  Lack of coordination, weakness or paralysis in any of the body part

When should you see a doctor?

If you experience significant trauma to the neck or head, accompanied by the above symptoms, then visit a doctor immediately. Spinal trauma or injuries is a debilitating condition and can deteriorate further if you do not seek medical intervention. In fact, if such an injury is not detected on time, you may have to face more severe complications. For instance, paralysis or numbness may develop immediately or gradually as blood clots and swelling occur in the surrounding region of the spine.

The doctor can detect spinal injuries using any of the following methods-

  CT Scan
  MRI
  X-ray

What is the treatment for spinal trauma?

An orthopaedic will recommend the correct treatment for spinal trauma or spinal cord injuries, depending on the severity of the condition.

  Medications - Intravenous medications can help reduce the pain and symptoms of acute spinal cord injury
  Immobilization - Braces, corsets, or neck collar can help realign and stabilize the spine
  Surgery - Surgery may be performed to remove bone fragments, herniated disks, foreign objects, or fractured vertebrae that are compressing the spine. Surgery also prevents deformity and pain in the long run.

Recovery starts typically within a week after the treatment. If you undergo surgery, you will have to wait a little longer to get back to your day-to-day activities. It is advisable that you follow up with your doctor and carry on physiotherapy for the first six months at least.

Spinal Trauma - When Should You Consult A Doctor?

Spine surgery is conventionally performed as  open surgery , which means the region being worked on is opened with a long entry point to permit the surgeon to view and access the area. Technical and scientific advances have permitted more back and neck conditions to be treated with a less obtrusive surgical technique. The minimal invasive spine surgery (MISS) does not include a long cut, and it prevents causing damage to the muscles around the spine. As a rule, this causes less pain after the surgery and a speedier and healthy recovery.

Spine surgery is normally suggested when non-surgical treatments like medicinal or exercise based methods have not helped in lessening the excruciating symptoms of your back problem. Moreover, surgery is just considered if your doctor can pinpoint the correct reason of your pain, for example, a herniated circle or spinal stenosis. 

MISS is also called less obtrusive spine surgery. In these procedures, surgeons utilise particular instruments to get to the spine through little cuts. The surgery process is as follows:

During the surgery, a little entry point is made and the tubular retractor is embedded through the skin.
It is also inserted into the delicate tissues down to the spinal cord.
This makes a passage to the little range where the problem exists in the spine.
The tubular retractor holds the muscles open and is set up all through the surgery.
The surgeon gets to the spine utilising the little instruments that fit through the focal point of the tubular retractor.
Any bone or disk material that is expelled goes out from the retractor.
Any gadgets needed for the fusion process, for example, screws or rods, are embedded through the retractor.
A few surgeries require more than one retractor.
Keeping in mind the end goal to see where to put the entry point and embed the retractor, the surgeon is guided by fluoroscopy.
This strategy shows ongoing X-ray pictures of the patient's spine on a screen throughout the surgery.
The surgeon additionally utilises a microscope to enlarge the view through the retractor.
Towards the end of the procedure, the tubular retractor is expelled and the muscles come back to their original position.
This restrains the muscle damage that is more ordinarily found in open surgeries.
It is very important to talk about these risks with your doctor before your surgery or procedure.

Infection: Antibiotics are consistently given to the patient some time before, during, and regularly after the surgery to reduce the danger of infections.
Bleeding: A specific measure of bleeding is normal; however, this is not commonly dangerous.
Pain in the grafted area: Some patients will encounter surgical pain at the bone joint site.
Recurring symptoms: A few patients may encounter a repeat of their side effects.
Pseudarthrosis: Patients who tend to smoke are more prone to pseudarthrosis. This is a condition wherein there is insufficient bone formation. In case that this happens, a minor surgery may be required.
Nerve damage: It is possible that the nerves or veins might be harmed during these operations. These complications are extremely uncommon.
Blood clots: Another complication is blood clots in the legs. This poses a threat because these clots can break off and settle in the lungs.

Minimally Invasive Spine Surgery - A Guide On What To Expect?

A broken bone or a fracture can be painful and it requires medical attention for the fracture to heal properly. Proper healing is necessary for the right alignment of the bone. A doctor chooses to either reduce or set the bone in terms of new alignment. The bone reduction can happen manually or surgically depending on the severity of the injury. A Surgical procedure known as the open reduction internal fixation is performed for serious fractures. It ensures that the all the broken pieces are fixed together and the injury can heal properly.
Post the fracture, the bone need to be immobilised for proper healing. This is generally achieved by imposing a cast. For fractures that are not severe in nature, a doctor might choose to impose a temporary cast so that simple motion can happen around the site of the injury. For serious fractures, a permanent cast is placed around the injury site. In the case of a shoulder injury, a patient is required to wear a sling so that the bones are immobilised.


Time Duration of a Therapy Session:
While the exact duration of physiotherapy can vary from individual to individual, it takes a minimum of 2-8 weeks for the fracture to completely heal. Certain fractures take more time to heal. The rate of healing also depends on the severity of the injury, pain threshold level of the patient, extent of work with the physiotherapist, the robustness of the physiotherapy program, extent of the injury of the soft tissue and certain other factors. Typically shoulder and neck injuries heal quicker than a fracture of the legs. The time duration of fracture healing also depends on the type of bone that has been affected.


Physiotherapy in a Hospital:
If the fracture happens in the ankle or leg, a physiotherapist might have to intervene in the hospital in order to teach patient about using assistive devices such as crutches and cane. Things that are taught during this time include using the device in order to climb stairs, right walking posture, getting into a car, taking the device off while sitting and such other techniques.


Physiotherapy at Home:
Physiotherapy can also happen from home if the doctor specifically instructs to do the same. This is typically done for people where the condition is too serious to go outside and get the physiotherapy done. Certain weight bearing restrictions are imposed around this time. The training remains the same as in the case with a hospital.


In the Clinic:
Once the patient becomes mobile enough, a doctor might suggest a patient go to a clinic to get the physiotherapy done. A physiotherapist evaluates certain things such as pain, range of motion, gait, flexibility etc. of the patient before suggesting a certain exercise plan. 




How Long Do You Need Physiotherapy Post-Fractures?

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

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