DR. MED. ULDIS KRUSTINS
Head of the Latvian Microsurgery Center. Certified traumatologist-orthopedist, microsurgeon, hand surgeon
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The Latvian Microsurgery Center (LMC) treats all types of wrist fractures.
The only place in Latvia where patients can receive the help of an LMC hand surgeon around the clock is the Emergency Medicine and Patient Admission Clinic of Riga East Clinical University Hospital “Gailezers”.
The Federation of European Societies for Surgery of the Hand (FESSH) has accredited the LMC as the Hand Injury and Replant Center, the only one in the Baltics.
Patients with suspected fractures of the wrist are advised to seek help on the day of or soon after the injury. In simple cases, when the fracture is not dislocated (the bone is in an anatomically correct position) and is stable, the patient will be given a plaster cast.
If the fracture is dislocated or unstable, the patient needs surgery.
Special attention is paid to the fracture of the boat bone or scaphoideum. LMC professionals specialize in the treatment of such fractures. It is the most commonly broken carpus bone.
Improper treatment of a wrist fracture results in inflammation (rheumatoid arthritis) and collapse of the joint over years, often leading to complete inability to work due to constant pain.
If the wrist fracture is not complicated and is detected early (during the first two weeks), the treatment is rather simple (plaster bandage), but long-lasting – up to 12 weeks.
However, if such treatment is unsuccessful (5-10% of all cases), a wrist operation with a pelvic bone transplant or a transfused (live) bone from the patient’s spine bone is required. A patient with a fracture of the base of the wrist should be ready for long-term treatment. Smoking significantly reduces the chances of healing.
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For patients with a suspected fracture of arm bones, we recommend seeking medical advice on the day of injury or the first days following the injury. In simple cases, when the fracture is not dislocated (the bone is located in the anatomically correct position) and is stable, a plaster cast will be applied to the patient. If the fracture has displacement or is instable (possible fracture displacement), surgical treatment is necessary. Particular caution is applied for a scaphoid fracture. The professionals of the Microsurgery Center are specialised in the treatment of scaphoid fractures. It is the most commonly fractured carpal bone.
As a result of improper treatment of this hand bone fracture, over many years, joint inflammation (arthritis) and degeneration develops, often ending with complete disability due to permanent pain. If the fracture of the hand bone is not complicated and is diagnosed early (during the first two weeks), then treatment is simple (plaster cast), worn for a period of 8 to 12 weeks at most. However, if such treatment is unsuccessful (5 to 10%), then hand surgery with pelvic bone transplantation is necessary or transplantation of (live) bone with blood supply from the patient’s radius. A patient with a fracture of any carpal bone should be prepared for long-term treatment. Smoking reduces the healing potential significantly.
Duration of the operation
From 30 min. up to 1.5 hours on average.
Anaesthesia
Regional or general.
Treatment
Outpatient.
Recovery
After the operation, local discomfort and pain are common yet are well controlled with analgesics. Wounds heal in two weeks. In the postoperative period, the patient needs to wear a plaster cast and bandage two or three times a week. After two weeks, the skin sutures are removed. The patient will need occupational therapy to restore the movement of fingers and the hand.
Outcome
The outcome of treatment depends on the type of fracture and the timing of treatment. Therefore, it is important to see a doctor in advance if a fracture of the arm is suspected.
How long should I walk with plaster after a wrist fracture?
Wrist bones grow in about 8-10 weeks. The hand must be immobilized during this time. At first, it is done with plaster, then it can be replaced with a lighter orthosis. It should be noted that immobilization can last up to three months.
Will the screw need to be removed from the boat bone?
Usually, a headless compression screw is inserted into the boat bone, which does not need to be removed. However, there may be situations where the screw moves and begins to interfere with the movement of the joint. Then it must be removed.
Hand bone fractures
660 €
The price of the operation includes surgery, anesthesia, hospital stay.
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