Wrist Fractures - Dr. Ze-Hui Han скачать в хорошем качестве

Wrist Fractures - Dr. Ze-Hui Han

What is a wrist fracture and why are they so common? With wrist fractures – we are mainly talking about the distal radius fracture. It's a big part of the hand surgery practice. It's a radius fracture – we can categorize to the different populations because of different reasons. Wrist fractures are very common in the winter because of the weather and snow – and most commonly we see wrist fractures in older females because of the osteoporosis or quality of the bone. So, it most commonly happens in the senior population because of the postmenopausal osteoporosis for bone quality in older women. But in the summer, we have more distal radius fractures that are associated with the sports, specifically with dirt biking. It's very popular in here. But many wrist fractures also come from car accidents, it’s associated with the higher energy of the injury and the younger population. What is the treatment for wrist fractures? The treatment for wrist fractures is very similar, but also uniquely different. For example, for the senior population – because we are dealing with older adults, we look at the function level of the person – not only the age. Someone may be a little bit of older, but their function level actually pretty good – so we're more aggressive on this kind of the treatment – meaning we utilize internal fixation to make it more close to the anatomic position. For the sports-related – that's because of the higher demanding of the job, and so we go more of the operation treatment. Why are wrist fractures more common? Our state of Iowa, we have a higher percentage of the senior population, and especially the female population. Also, we have a long winter – so we have a lower exposure to the sunlight. So, the vitamin D level is another concern. And also, genetically the Caucasian female always as a group has a higher risk of the postmenopausal osteoporosis than the counter part of the African American group. So that's the reason we have so many of the distal radius fractures in the winter because when it’s slightly slippery – you can break the wrist. I've been here 17 years in state of Iowa. I love it, but we do see these kinds of the patient often. How do you decide to treat a wrist fracture surgically or non-surgically? It's a judgment call from the surgeon. Mainly, we look at it is that two questions. Number one – is this patient with the significant interruption of the joint surface displacement. It's how far did this a fracture make the bone structure shy away from the normal structure. If it is a very bad displacement, you have to do it surgically because you need to reduce the fracture. Number two – it’s based on the patient’s demand level and the patient’s medical conditions. For example, if the patient is very senior population with a lot of medical problems, we may not want to treat it a surgically and we want to treat it conservatively. How important is physical therapy/occupational therapy for recovery from a wrist fracture? We have developed a very good program here at Iowa Ortho that combines the occupational therapy and also the surgery. We evaluate the patient preoperatively and arrange all the therapy program and also the surgery. We let the patient start the therapy right after the surgery and the majority of people actually recover very well. Regardless if you treat the patients surgically on non-surgically, the goal is to let patient have a speedy recovery and to have them recover to pre-injury level as much as you can. The therapy is very important because of the range of motion recovery is really important. Because of the injury to the soft tissue, the cutting of the tissue during the surgery – and the bone, you put hardware (in the bone) – all of this is another damage to the to the patient’s body. With therapy – because we have a very good program, we occupational therapy specialists who specialize on the hand, so they have to get an added qualification examination to get this – they reduce the swelling of the edema of the patient. What does recovery look like from a wrist fracture? Basically, with all this program, the patient will have early range of motion, function level and with up to eight to 10 weeks of recovery, the patient will have better range of motion and better function. Especially for the older patient I want to stress this one because when their function level quicker recover to the pre-injury, it's good for everything because they go back to their original level lifestyle. They're happier. And so they are not going to go down having other associated problems because it will directly affect the whole body. For more information: https://www.iowaortho.com/service/han...