Introduction
A complex wrist fracture is one of the most significant injuries affecting the wrist joint, often involving multiple broken pieces of bone, joint surface disruption, and loss of alignment. At Specialty Orthopaedics Braselton, Dr. Thomas Neustein—a board-certified hand and upper extremity surgeon—provides precise diagnosis and advanced surgical management for these challenging injuries. For patients from Braselton, Flowery Branch, and Buford, his goal is to restore motion, strength, and full wrist function through evidence-based, patient-focused care.
Understanding the Anatomy of the Wrist
The wrist is composed of eight small bones known as the carpal bones, which connect the two forearm bones (the radius and ulna) to the hand. The radius bone—especially its distal end near the wrist—is the most commonly fractured part of the upper extremity. When a fracture disrupts the alignment or stability of these wrist bones, pain and deformity quickly follow.
Why Wrist Fractures Are So Common
Wrist fractures occur frequently because people instinctively brace themselves during a fall, landing on an outstretched hand. The force travels up the forearm bones, causing the radius breaks or bending at its weakest point near the thumb side. Sports injury, a high energy injury, or even a simple slip on ice can result in a broken wrist.
Types of Wrist Fractures
There are several patterns of wrist fractures, and understanding the type helps determine the best treatment options.
Distal Radius Fractures
A distal radius fracture involves the lower part of the radius bone near the wrist joint. These are the most common type of wrist fracture and can range from stable to complex depending on displacement and joint involvement.
Colles Fracture
A Colles fracture occurs when the radius tilts upward after a fall on an extended wrist. This causes the classic "bent wrist" appearance.
Smith Fracture
A Smith's fracture is the reverse of a Colles; the wrist bends toward the palm side after a fall on a flexed wrist. These are less common but may be more unstable.
Extra Articular Fracture
An extra articular fracture does not involve the joint surface. It may be treated with nonsurgical treatment if stable.
Intra Articular Fracture
An intra articular fracture extends into the joint surface of the wrist. These are often displaced fractures requiring precise reduction and internal fixation to restore normal motion.
Comminuted and Complex Fractures
Some fractures involve multiple broken bones or broken pieces that make reduction difficult. These severe fractures often require open reduction and fragment specific fixation to reconstruct the joint.
Risk Factors for Wrist Fracture
Common risk factors include age, osteoporosis, and poor bone health. Other risk factors include smoking, diabetes, or prior wrist injuries that weaken the bone. High energy injuries, such as car accidents, can cause displaced fractures in even young, healthy patients.
Recognizing the Symptoms
Common symptoms include:
- Immediate pain after trauma
- Visible deformity or "bent wrist" appearance
- Swelling and bruising over the thumb side
- Difficulty moving fingers or rotating the wrist
- Numbness from pressure on surrounding soft tissues
If you experience these signs, seek immediate medical attention at our Braselton orthopedic clinic or a local urgent care center.
Diagnosis and Evaluation
Proper diagnosis begins with a detailed physical exam and imaging. X-rays identify the fracture displacement, while CT scans evaluate intra articular fractures or hidden damage to the carpal bones and radial styloid. Dr. Neustein personally reviews all imaging to ensure the bones are properly aligned before creating a customized treatment plan.
Initial Management and Immobilization
For stable distal radius fractures, nonsurgical treatment may include a splint or cast. A plaster splint or removable splint may be used initially to control swelling. The goal is to maintain proper alignment and allow the bone heals naturally.
In some cases, closed reduction (manual manipulation under local anesthesia) can realign displaced fragments without surgery. Follow-up imaging confirms whether the bones aligned remain stable during fracture healing.
Surgical Treatment for Complex Fractures
When the fracture is unstable, surgical treatment offers the best long-term outcome. Dr. Neustein uses open reduction internal fixation to realign and stabilize the fracture with plates and screws. This approach restores the correct position of the distal radius and supports proper healing.
For select cases, he may also use:
- External fixation or an external fixator for temporary stability
- Bone grafting for severe fractures or bone loss
- Fragment specific fixation for multiple joint fragments
His training in orthopedic surgery and microsurgical technique allows precise restoration of the joint and surrounding structures.
The Importance of Early Treatment
Early treatment is essential to prevent stiffness, loss of motion, and arthritis. Delaying care increases the likelihood of joint involvement, potential complications, or the need for second surgery.
Recovery After Wrist Surgery
After fixation, the wrist is typically protected in a brace or light cast. Six weeks is the average time before beginning full movement, though fracture healing can vary depending on the patient's bone health and fracture type.
Patients begin gentle motion exercises soon after surgery, followed by formal physical therapy once the surgeon clears them to move more freely.
The Role of Physical Therapy
Physical therapy helps restore strength, flexibility, and coordination after a broken wrist. Early, guided motion prevents stiffness and scar tissue buildup. Our team teaches patients to safely regain motion, improving overall functional outcomes.
Therapy includes:
- Range-of-motion exercises
- Strength training for grip and forearm stability
- Scar and swelling management
- Home exercise instruction to supplement therapy sessions
When you start physical therapy early and stay consistent, results are faster and more complete.
How the Bone Heals
During fracture healing, new bone tissue bridges the break. Most fractures unite within six weeks, but full remodeling may continue for months. Dr. Neustein monitors each patient's progress closely to ensure the bone heals in a stable and functional position.
Monitoring and Follow-Up
Regular follow-up ensures proper progress. Patients are seen frequently in the first few weeks to ensure no fracture displacement or hardware issues. Long-term visits assess strength, range, and wrist function as the bone heals.
Preventing Complications
To prevent infection or delayed healing, patients must follow post-operative care instructions carefully. Keep the incision clean, maintain a balanced diet for good bone health, and attend all follow-up appointments. Proper healing depends on both surgical skill and patient compliance.
Colles and Smith Fractures in Detail
A Colles fracture is the classic distal radius fracture caused by a fall on an extended wrist, where the radius tilts upward. A Smith fracture, on the other hand, results from impact on a flexed wrist, with the bone tilting toward the palm side. Both types affect the wrist joint differently but share similar treatment goals—restore alignment and maintain motion.
The Role of External Fixation and Internal Fixation
Some complex cases benefit from external fixation to stabilize fragments temporarily. Others require internal fixation with low-profile hardware. Both methods aim to keep bones aligned for optimal proper healing and to avoid joint stiffness.
Rehabilitation and Home Care
Once cleared, patients begin active motion exercises to regain function. Light strengthening and stretching continue for several months. Consistency with therapy and home exercises leads to the best functional outcomes.
Sports Injuries and High-Energy Trauma
Athletes and active individuals in Braselton occasionally sustain high energy injuries to the wrist from falls, cycling accidents, or impact sports. Dr. Neustein applies advanced treatment options for these patients, emphasizing quick stabilization, early therapy, and prevention of long-term stiffness.
Addressing Scaphoid and Carpal Bone Fractures
While the distal radius is the most commonly fractured long bone in the arm, scaphoid fracture and carpal bones injuries are also seen. These small fractures can be overlooked and may require specialized imaging or surgery for proper healing.
Maintaining Proper Alignment and Wrist Function
Whether treated surgically or with casting, maintaining proper alignment ensures long-term wrist function. Even a few millimeters of malalignment in a distal radius fracture can lead to decreased strength or rotation. Dr. Neustein ensures every radius bone and radial styloid is restored to its natural correct position for optimal mechanics.
Long-Term Prognosis
With expert care, most fractures heal successfully without chronic pain or stiffness. Patients usually regain normal grip strength, flexibility, and range within several months. The combination of expert fixation and early motion provides excellent functional outcomes and a high rate of patient satisfaction.
The Importance of Bone Health
Bone health plays a critical role in preventing fractures. Calcium, vitamin D, and regular weight-bearing exercise help maintain bone density. Patients are encouraged to follow up with their primary care physician to ensure good bone health, especially after their first broken bone.
Why Choose Dr. Neustein in Braselton
Dr. Neustein's practice stands out for its commitment to individualized care. As a board-certified hand and upper extremity surgeon Braselton trusts, he combines technical precision with patient-centered compassion. His expertise in both surgical and nonsurgical treatment gives each patient access to the full spectrum of treatment options under one roof.
Specialty Orthopaedics Braselton: Advanced Wrist Care Close to Home
The Braselton orthopedic clinic offers state-of-the-art imaging, casting, and on-site therapy, ensuring smooth transitions from diagnosis through recovery. Patients appreciate having high-level care in a convenient local setting—without the need to travel to a large hospital.
Schedule an Appointment
If you've suffered a broken wrist, distal radius fracture, or any other wrist injury, don't delay care. Early treatment ensures better outcomes and shorter recovery time. Schedule your consultation with Dr. Thomas Neustein at Specialty Orthopaedics Braselton today for expert evaluation, personalized treatment, and restored confidence in your hand and wrist function.
