08 July, 2011
Broken Wrist Complications
The human wrist is a complex joint that must move in many directions to accomplish both gross, or large, motions as well as fine activities. Because of the complexity of the joint, complications from a broken wrist can result in functional deficits as well as chronic pain syndromes. There are several broken wrist complications that can develop.
Carpal Tunnel Syndrome
Wrist fractures can contribute to acute carpal tunnel syndrome, also known as fracture-induced carpal tunnel syndrome. Because of the mechanisms of injury involved in wrist fractures, the main nerve that passes through the bony carpal tunnel at the wrist, called the median nerve, can suffer from abnormal pressure placed upon it from displaced bone fragments. Falling directly on the wrist can cause a contusion of the nerve resulting in bruising within the nerve tissue and pressure from swelling.
When wrist fractures involve the normally smooth cartilage surfaces of the bones that make up the wrist joint, restoring these surfaces to pre-fracture smoothness is impossible. Proper setting techniques and even surgical reduction can sometimes minimize the effects. This creates a situation of uneven surfaces coming into contact with one another. The friction and abnormal wear on the joint cartilage from these uneven surfaces damages and causes accelerated degeneration of the smooth hyaline cartilage abnormally and prematurely. This is known as post-traumatic arthritis
Chronic Pain and Stiffness
A fractured wrist typically takes about eight weeks to heal; this will vary among patients and be dependent upon other factors including bone quality and fracture severity. Symptoms such as chronic pain, aching and stiffness, however, can last for several months after solid healing has been achieved. According to the American Association of Orthopaedic Surgeons, recovery time can extend to one year with two or more years of subsequent aches and stiffness. Sometimes the pain and stiffness is permanent.
Complex Regional Pain Syndrome
Complex regional pain syndrome, or CRPS, can be a serious and extremely debilitating complication of wrist fractures. The exact cause of CRPS, also known as reflex sympathetic dystrophy, or RSD, is not truly understood, but it has been theorized that the syndrome can be a result of a dysfunction of the person’s sympathetic nervous system that controls blood flow and sweat gland activity. Involvement of this nervous system is normal, but in some cases, normal quieting of the reaction does not occur. Symptoms of CRPS/RSD can include extreme pain, out of context for the injury, skin changes, changes in hair and nail growth and extreme hypersensitivity to touch. According to MDGuidelines, CRPS/RSD can occur in 10 to 30 percent of people who experience various fractures and/or contusions.
- Fractura de radio image by Cano from Fotolia.com