Why do some specialists recommend early surgery following a wrist fracture?
Not all wrist fractures are created equal. The common type (Colle’s fracture) occurs one inch back from the wrist joint, with little bone fragmentation and no injury to the joint cartilage. More severe types of fractures have additional fragmentation, which may involve the joint cartilage. This type of fracture is inherently unstable and will often settle over the next 2-4 weeks, even if the initial position is satisfactory. By the time the fracture is then healed at six weeks, the joint surface has healed with gaps and depressions, which leads to arthritis and long term wrist pain. In these more severe fracture types, insertion of pins through small skin incisions combined with an external traction device (external fixator) may help maintain the bone alignment during the healing period. Newer external fixators may even allow some wrist motion. In this way, wrist deformity and the need for more aggressive surgery can be avoided. David J. Slutsky, M.D. Diplomate, American Board of Ortho
