Corrective Osteotomy for Wrist Fractures
Broken wrist treatment in Sydney
Wrist fractures are among the most common types of fractures. In most cases, after a bone is broken, the fracture will heal on its own. However, a variety of possible issues can affect the healing process, leading the bone to heal incorrectly. This can leave the bones of the wrist out of alignment, leading to pain and dysfunction and even increasing the risk of arthritis later on.
To address these issues, a procedure known as corrective osteotomy may be used. Also known as “re-breaking” the bone, this involves reshaping one or more bones in order to bring a joint into better alignment. After a wrist fracture that doesn’t heal correctly, corrective osteotomy can help to restore the short-term and long-term function of the wrist.
Why might a bone need to be re-broken?
When a fracture doesn’t heal correctly, this is known as malunion. One common cause of malunion is a delay in medical treatment for a fracture, so that the fracture begins healing while the pieces of the bone are not in good alignment. In most cases, medical treatment of a fracture – either nonsurgical (with a cast or splint) or surgical (using pins, plates, or screws to hold the pieces of the bone in place) – is able to prevent malunion.
However, even with proper treatment, malunion can sometimes still occur. This is more common in people with osteoporosis (low bone density), because the bone tissue may not be robust enough to heal well. Other chronic diseases, such as diabetes, can also impair healing and result in malunion. In addition, medical treatment isn’t always successful at holding the pieces of the bone in good alignment. For example, a cast that’s too loose or hardware that’s not secured properly can allow the bone fragments to slip out of alignment, leading to malunion.
Malunion of a wrist fracture can lead to symptoms like pain, tenderness, stiffness, and difficulty moving the wrist. These symptoms can impact a person’s ability to live their daily life and do the things that they want to do. Over the long term, malunion also increases the risk of arthritis in the wrist.
Corrective osteotomy is used to correct the issues caused by malunion. By restoring the bones of the wrist to good alignment, it can help to address both the short-term and long-term issues caused by malunion.
How is corrective osteotomy performed?
Osteotomy is a highly personalized procedure, and the exact specifics of the surgery will depend on what’s needed to return your bones to good alignment.
Your surgeon starts by making detailed measurements of the bones of your forearm, wrist, and hand. This is usually done using a CT scan, which provides a digital 3D image of the bones. Using computer modeling, your surgeon can then calculate the exact changes that are needed to create proper alignment of the wrist joint. This may involve either shortening or lengthening certain bones, or reshaping one or more bones. Based on the models, custom 3D printed guides are created.
During the procedure, the surgeon will make an incision, and will then cut and reshape the bones as needed. The custom guides that were previously created for you are used during surgery, allowing your surgeon to precisely resize and reshape your bones according to the exact plan that was developed. Plates, screws, or pins may be used to hold the pieces of the bones in place while they heal. This hardware is often left in place permanently, but in some cases, it may be removed later.
The use of bone grafts in corrective osteotomy
A gap in a bone may be created during the osteotomy process. For example, a damaged part of a bone may need to be removed, or a bone may need to be lengthened. While fractures can heal if the pieces of the bone are in contact with each other, the body is unable to fill in a larger gap in a bone.
To allow for proper healing, it’s necessary to fill in any gaps left in the bone after reshaping or resizing it. This is done by placing a bone graft, which may be taken from a different part of the patient’s own body (such as the hip crest) or may involve using donor bone or synthetic materials. Beyond filling in gaps in a bone, bone grafts may also help to encourage healing by stimulating the growth response of the bone.
Healing from corrective osteotomy
After corrective osteotomy, the wrist needs to be immobilized as it heals. This involves wearing a cast or splint for several weeks after the procedure. It’s crucial to maintain proper alignment of the bones as they heal from the procedure. Otherwise, similar issues may occur again, which could potentially lead to the need for another surgery.
Physical therapy is an important part of the healing process, and it usually begins shortly after surgery. Most people need 1 to 2 weeks completely off from work, and it can take 6 to 8 weeks or even longer before you’re ready to return to doing physically demanding work with the affected arm. It’s important to be diligent with your physical therapy and to give your body the rest that it needs, so you can get the best possible outcome from your surgery.
Are you experiencing wrist issues after a broken wrist?
If you had a wrist injury and are now experiencing wrist issues, it’s a good idea to seek medical attention as soon as possible. A doctor can evaluate you and determine what’s causing the problems that you’re experiencing. In some cases, surgery to reshape the bones of your wrist may help to improve both the short-term and long-term functioning of your wrist joint.
As an expert in surgical treatment of the hand and wrist, Dr. Sungaran has the skills necessary to perform corrective osteotomy after a wrist fracture. A consultation will allow him to evaluate your wrist and give advice about the best ways to improve symptoms like wrist pain, stiffness, or limited range of motion. He recommends surgery when he believes it would be the best way to relieve your symptoms, but if he believes that non-surgical treatment would be likely to benefit you, he’ll often recommend trying that first. Simply contact our front desk staff to schedule your appointment.
