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A broken or fractured wrist is usually caused by an outstretched hand that takes the full impact of a fall. By bracing oneself with the hand, the impact of hitting the ground causes the bone to jar and snap or fracture, as it does not have the strength or flexibility to handle such a hard knock. Common signs of a broken or fractured wrist include severe localised pain, swelling in and around the wrist area and increased levels of pain when the wrist is extended or moved.
A fracture known as a capitate wrist fracture accounts for a very small percentage of all wrist fractures, and although only a small percentage of people suffer from this particular type of broken wrist, it is one of the more severe and complicated types of break. ‘Capitate’ is the name given to one of the eight smaller bones that form the wrist complex, and these small bones can snap without warning when under too much pressure. An isolated capitate wrist fracture can occur, but generally these types of fractures occur together with the fracture of another carpal bone known as the Scaphoid. This type of broken wrist can take a long period of time to heal and a wrist support may be required during the healing time and for a few months thereafter. Due to the nature of the capitate bones they may need protection for longer and a wrist support allows for this, while still ensuring a degree of freedom of movement.
The capitate is one of the areas of the body that has a poor blood supply and this can have a negative influence on the healing process, slowing it down considerably. There can also be minor complications during the healing of this break, and these may manifest as a diffuse ache when the wrist is moved, and the pain may linger for many months. This diffuse ache is due to a breakdown of the capitate caused by the lack of healing and blood supply which is termed avascular necrosis. If symptoms of avascular necrosis are still evident 6 weeks after a break or fracture, the bone has potentially not healed and a patient should visit their doctor.
In order to aid the healing of a broken wrist, the arm is immobilised in a cast or brace. A doctor may have x-rays taken of the wrist and these will determine the severity of the break and whether surgery to fix the capitate wrist fracture is required. If a doctor decides the broken wrist requires a cast, one will be fitted and worn for the recommended period of time, and once this cast has been removed a patient will need to undergo physiotherapy treatment to help them regain the normal range of movement of the wrist joint and to build up strength in the muscles that work in conjunction with the wrist bone. Exercises using tools such as hand therapy balls, therapeutic putty and finger and grip strengtheners will be used to strengthen the muscles around the wrist and to resolve localised swelling. After the removal of a cast a wrist support is often suggested, as it will protect the wrist and hold it in position when not exercising.