Fractures and Dislocations

Since the hand and wrist are so important in everything we do, we involve our hands and arms in myriad activities. Unfortunately, sometimes this leads to trauma, fractures and dislocations.

The radius is the larger of the 2 forearm bones. The most common hand and wrist fracture involves the wrist end of the radius. This fracture may be either simple or complex. Proper treatment is absolutely critical to obtaining a good recovery, and involves accurate diagnosis, X-ray, and proper treatment. Treatment may be as simple as a cast for immobilization, or as complex as placement of pins, screws and plates under arthroscopic and fluoroscopic (X-ray) guidance. There is no one treatment that is best for all radius or wrist fractures. Rather, individual evaluation followed by treatment based on science, clinical study and experience must be accomplished. Only a skilled surgeon, thoroughly familiar with both non-operative and operative treatments, can make the informed decision as to the best treatment.

Dr. Leibovic has contributed to the literature in wrist fractures, and continues to treat patients with wrist fractures on an individualized basis with their particular injury, occupation, avocation and needs in mind.

Hand therapy is a fundamental part of recovery from wrist fracture, no matter how the fracture is treated. Dr. Leibovic directs the hand therapists at Virginia Hand Center in striving to achieve the most rapid return to function and work possible after such injury.

The scaphoid is the most commonly fractured bone in the carpus (the small bones between the forearm bones and the finger bones). While common, treatment of the scaphoid fracture can be very problematic. All bones require a blood supply to heal, and the blood supply of the scaphoid can be quite tenuous after fracture. Furthermore, inadequately treated scaphoid fractures have a high rate of subsequent problems for patients. Though it may happen years after the fracture, a poorly treated or untreated scaphoid fracture can lead to significant arthritis and pain, with limitation of motion and function.

At Virginia Hand Center, the newest and most appropriate techniques are advocated for patients with scaphoid fractures, just as they are for all hand and arm conditions.

The hand and wrist have a complex bony and ligament structure, and are subject to many possible bone and ligament injuries. Only a few of interest are discussed here.