Hand and Wrist Fracture

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Simple and complex fractures of the hand or wrist are treated by our hand and wrist specialists, who have the skills and experience to provide you with the best-possible outcome. Our experts have developed some of the latest treatment approaches, including improved implants, for better healing and devices for fractures of specific bones in the hand and wrist.

Duke Orthopaedic Clinics

Our hand and wrist specialists see patients at Duke Orthopaedic clinics in Durham and Raleigh. Find one near you.

Expert Care for Hand and Wrist Fractures

Bones in the hand and wrist can break during contact sports, falls on an outstretched hand, motor vehicle accidents, and other traumas. Fractures may be accompanied by injuries to nearby tendons, ligaments, nerves, vessels, and other structures and can range from simple to complex. In severe cases, fractures may be open, meaning that bone fragments pierce the skin. Open fractures require immediate medical attention. Our hand and wrist specialists offer an array of treatments for these injuries, from splinting to surgery.

Imaging, such as X-ray or MRI, may be used to assess your injury accurately and quickly and help your doctor determine the best way to proceed with your care. 

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Our convenient orthopaedic urgent care clinic is open seven days a week. Get fast service with no long waits and no unnecessary exposure to illness. No appointment is needed; walk-ins are welcome.

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Nonsurgical Treatments

Many simple fractures of the hand and wrist can be treated without surgery. Whenever possible, our specialists provide you with a safe and effective nonsurgical plan. 

Splinting and Casting

If your broken bone is still aligned well, a cast or splint can hold it in position until it heals. The type of cast, splint, or brace will be tailored to your injury and condition.

Closed Reduction

If your broken bone is out of place, the fragments can sometimes be realigned with without surgery. Typically, you will receive medication to block pain during the procedure. Sometimes, a sedative or general anesthesia may be used. In most cases, X-rays taken during the procedure ensure the best-possible outcome. After closed reduction, you will wear a cast, splint, or brace to keep the bone aligned until it heals.

Occupational Therapy

Our hand therapists are occupational therapists with advanced training in hand, wrist, and elbow care. They provide personalized therapy to help you regain function as soon as possible. Occupational therapy may be recommended even if you do not have surgery to help you recover from your fracture. 

Surgical Treatments

Surgery may be necessary for more complicated fractures. Our surgeons are experts in the full range of surgeries for hand and wrist fractures.

Open Reduction

For an open fracture -- when bone pierces the skin -- the skin is opened so your surgeon can view the fracture and precisely realign the bones. Soft tissue is cleaned and repaired to prevent infection.

Internal Fixation

Pins, plates, rods, or other devices may be implanted to hold bone fragments together and in alignment. In many cases, this may allow for an earlier return to normal activities. Internal fixation means that the implanted device rests under the skin and can only be seen with imaging such as MRIs or CT scans.

External Fixation

For some severe fractures, a stabilizing device outside the body is used to hold the bones together as they heal. This metal and carbon fiber frame is attached to the bone with two or more pins that pass through the skin. It may be used along with internal fixation. This is a temporary device that is removed once the bone heals. 

Bone Grafts

Some fractures heal better when new bone is grafted to the site of the break. The graft may be an autograft taken from your arm, leg, hip, or another bone in your body, or it may come in sterilized form from another person who has donated it (allograft). Some grafts are completely synthetic and are made in a lab. Grafts can stimulate new bone to form at the fracture site and promote healing.

Best Orthopaedic Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Why Choose Duke

We Treat the Full Range of Hand and Wrist Conditions
This includes injuries in amateur and professional athletes of all ages. Many come to Duke from other parts of the country for our expert sports-injury care. We often help patients who come to us after treatment at other centers has failed.

Advanced Care from Skilled Experts
Our hand and wrist surgeons are skilled in the most advanced surgical techniques for repairing injuries, correcting deformities, and restoring function. This includes advanced fracture care, wrist fusion, and even wrist replacement surgeries. Whenever possible, our surgeons offer minimally invasive procedures, which can reduce your healing time.

Specially Trained Hand Therapists
Occupational therapists who specialize in hand and wrist conditions are located in our clinics. They provide customized therapy to help you recover from surgery as quickly as possible -- or avoid the need for surgery altogether.

We’re Innovators and Teachers
Our hand and wrist specialists have developed new treatment techniques and devices that are now used across the country. They’re also teachers who train the next generation of orthopaedic specialists in complex surgical procedures.

This page was medically reviewed on 09/05/2023