eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

Carpal Fractures: Follow-up

Author: George J Kouris, MD, Senior Fellow, Department of Plastic and Reconstructive Surgery, Rush-Presbyterian-St Luke's Medical Center
Coauthor(s): Robert R Schenck, MD, Associate Professor, Department of Plastic Surgery, Rush Medical College; Director, Section of Hand Surgery, Department of Plastic Surgery, Rush University Medical Center
Contributor Information and Disclosures

Updated: Mar 12, 2008

Outcome and Prognosis

Carpal fractures can be among the most challenging orthopedic injuries to evaluate. Because no single treatment modality ensures an acceptable result for all carpal fractures, the treating physician must possess the knowledge and skill necessary to achieve an acceptable anatomic outcome. If diagnosed promptly and treated appropriately, the vast majority of these fractures will heal. The early establishment of anatomic alignment provides the best opportunity for the later recovery of wrist motion and function.

Future and Controversies

Operative fracture repair has traditionally revolved around the use metal implants, including pins, plates, and screws. In most cases, this hardware is later removed, sometimes with an open procedure. The future of bone fixation may involve resorbable prosthetic implants. Most bioabsorbable implants are made of polymers that degrade slowly over time, eliminating the need for a second retrieval operation. Bioresorbable materials with mechanical properties comparable to those of traditional pins, plates, and screws are currently being investigated. These may perhaps provide an alternative approach to carpal fracture fixation.

 
Acknowledgments

The authors and editors would like to acknowledge the contributions made to this article by Spero JV Theodorou, MD.



More on Carpal Fractures

Overview: Carpal Fractures
Workup: Carpal Fractures
Treatment: Carpal Fractures
Follow-up: Carpal Fractures
Multimedia: Carpal Fractures
References
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References

  1. Chloros GD, Wiesler ER, Poehling GG. Current concepts in wrist arthroscopy. Arthroscopy. Mar 2008;24(3):343-54. [Medline].

  2. Hove LM. Fractures of the hand. Distribution and relative incidence. Scand J Plast Reconstr Surg Hand Surg. Dec 1993;27(4):317-9. [Medline].

  3. Simank HG, Schiltenwolf M, Krempien W. The etiology of Kienbock's disease-a histopathologic study. J Hand Surg. 1998;3:63-69.

  4. Geissler WB. Carpal fractures in athletes. Clin Sports Med. Jan 2001;20(1):167-88. [Medline].

  5. Barnaby W. Fractures and dislocations of the wrist. Emerg Med Clin North Am. Feb 1992;10(1):133-49. [Medline].

  6. Cohen MS. Fractures of the carpal bones. Hand Clin. Nov 1997;13(4):587-99. [Medline].

  7. Seitz WH, Papandrea RF. Fractures and dislocations of the wrist. In: Rockwood and Green's Fractures in Adults. 5th ed. Phliadelphia, Pa: Lippincott, Williams & Wilkins; 2001:749-799.

  8. Watson HK, Weinzweig J. Physical examination of the wrist. Hand Clin. Feb 1997;13(1):17-34. [Medline].

  9. Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg [Am]. Sep 1980;5(5):508-13. [Medline].

  10. Welling RD, Jacobson JA, Jamadar DA, Chong S, Caoili EM, Jebson PJ. MDCT and radiography of wrist fractures: radiographic sensitivity and fracture patterns. AJR Am J Roentgenol. Jan 2008;190(1):10-6. [Medline].

  11. Calandra JJ, Goldner RD, Hardaker WT Jr. Scaphoid fractures: assessment and treatment. Orthopedics. Aug 1992;15(8):931-7. [Medline].

  12. Adolfsson L, Lindau T, Arner M. Acutrak screw fixation versus cast immobilisation for undisplaced scaphoid wrist fractures. J Hand Surg [Br]. Jun 2001;26(3):192-5. [Medline].

  13. Trumble TE, Gilbert M, Murray LW, et al. Displaced scaphoid fractures treated with open reduction and internal fixation with a cannulated screw. J Bone Joint Surg Am. May 2000;82(5):633-41. [Medline].

  14. Panchal A, Kubiak EN, Keshner M, Fulkerson E, Paksima N. Comparison of fixation methods for scaphoid nonunions: a biomechanical model. Bull NYU Hosp Jt Dis. 2007;65(4):271-5. [Medline].

  15. [Best Evidence] Leung F, Tu YK, Chew WY, Chow SP. Comparison of external and percutaneous pin fixation with plate fixation for intra-articular distal radial fractures. A randomized study. J Bone Joint Surg Am. Jan 2008;90(1):16-22. [Medline].

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Further Reading

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Keywords

scaphoid fractures, triquetral fractures, lunate fractures, pisiform fractures, trapezial fractures, hamate fractures, capitate fractures, wrist fractures, broken wrist

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Contributor Information and Disclosures

Author

George J Kouris, MD, Senior Fellow, Department of Plastic and Reconstructive Surgery, Rush-Presbyterian-St Luke's Medical Center
George J Kouris, MD is a member of the following medical societies: American College of Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Robert R Schenck, MD, Associate Professor, Department of Plastic Surgery, Rush Medical College; Director, Section of Hand Surgery, Department of Plastic Surgery, Rush University Medical Center
Robert R Schenck, MD is a member of the following medical societies: American Association for Hand Surgery, American College of Surgeons, American Medical Association, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, American Society of Plastic Surgeons, Chicago Medical Society, and Illinois State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Michael S Clarke, MD, Clinical Associate Professor, Department of Orthopedic Surgery, University of Missouri-Columbia School of Medicine
Michael S Clarke, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, American Association for Hand Surgery, American College of Surgeons, American Medical Association, Arthroscopy Association of North America, Clinical Orthopaedic Society, Mid-Central States Orthopaedic Society, and Missouri State Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Michael Yaszemski, MD, PhD, Associate Professor, Departments of Orthopedic Surgery and Bioengineering, Mayo Foundation, Mayo Medical School
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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