04 / TRAUMA
Fracture Fixation & Trauma Surgery
Fracture care balances the position of the bone, the stability of the injury and the need for movement. Many fractures heal with support alone. Surgery is considered when alignment, stability or associated injuries make it appropriate.
Understand the pathway01 / WHAT THIS TREATMENT ADDRESSES
Understand what can change.
Wrist fractures
Distal radius and scaphoid fractures behave differently. Fixation may stabilise displaced or unstable bone; a scaphoid also needs attention to its blood supply and risk of non-union.
Hand, finger & complex injuries
Treatment considers finger rotation, joint surfaces, tendons, ligaments and nerves together. A finger that crosses its neighbour when bending can lose useful grip even if the external deformity seems small.
02 / WHEN TREATMENT IS CONSIDERED
A reason to intervene.
A reason to be careful.
Examination checks circulation, sensation, wounds and alignment. X-rays usually establish the fracture pattern; CT can clarify complex joint damage. Stable fractures may need a splint, cast or strapping. Reduction or fixation may be considered when position is unacceptable, cannot be maintained, or a joint or other structure needs repair.
03 / BEFORE THE PROCEDURE
A clear plan before the day.
Acute injury planning includes swelling, skin condition, other injuries and general health. Bring previous images and medication information if available. Some complex injuries need urgent or staged care rather than one operation. Ask how the proposed fixation affects movement and follow-up.
Bring your questions.
Review medicines, allergies and health conditions with the team. Follow your own instructions about fasting and medication changes; do not stop prescribed treatment on your own.
Ask what help, transport and time away from work you may need.
04 / THE PROCEDURE
A PATIENT GUIDE / THREE KEY STAGESPrecision in every step.
A selected distal-radius fracture is shown with a palmar plate supporting the bone below the wrist joint. Screw heads sit on the plate and fixation remains within the radius; it does not cross the joint surface. Implant choice and position depend on the fracture.
- Distal radius
- Fracture region
- Volar plate concept
- Joint surface remains clear
The scaphoid is on the thumb side of the proximal wrist. This example shows a waist fracture and a screw-like fixation concept along the bone’s long axis. The ends remain within the bone. The approach and need for surgery vary with the fracture and healing.
- Scaphoid
- Fracture through the waist
- Internal fixation concept
- Radius
One metacarpal shaft fracture is shown with a simple plate fixation concept. Alignment, especially rotation, matters for fingers to close into a useful grip. The implant is confined to the fractured metacarpal, with neighbouring joints left clear.
- Metacarpal bone
- Fracture
- Fixation concept
- Finger joints remain free
An example proximal phalanx fracture is shown with small crossing fixation wires confined to the bone. Real treatment may instead use a splint, reduction, screws or plates. Stability is balanced with the need to protect movement and avoid stiffness.
- Proximal phalanx
- Fracture
- Selected wire fixation concept
- Adjacent joints
Assess & align
Identify the damaged structures and restore bone or joint alignment where possible.
Stabilise
Selected fractures are held with appropriate wires, screws, plates or other support while healing occurs. Associated soft-tissue damage is addressed as needed.
Protect & review
A dressing, splint or cast may be applied. Follow-up examination and imaging guide safe movement and loading.
05 / ANAESTHESIA & THE DAY
The plan is personal.
Regional or general anaesthesia may be used; some smaller injuries can be treated under local anaesthesia. Day surgery is possible for many injuries, but significant trauma, swelling or other medical needs can require admission. The plan is based on the whole injury.
06 / RECOVERY
PROTECT → MOVE → STRENGTHENProgress has
its own pace.
These are guideposts, not personal clearance dates. Your operation, healing and clinical review determine the next step.
Distal radius fixation
First days
Swelling & protection
Care for the dressing or splint and move uninvolved joints as advised.
Early follow-up
Position & wound check
Review healing, X-rays and when wrist movement can begin.
Around 6 weeks onward
Assess bone healing
Healing and fixation stability guide increasing use. Six weeks is not automatic clearance for heavy loading.
Following months
Strength & function
Therapy and graded use address stiffness. Recovery can continue well beyond initial bone healing.
Scaphoid / hand trauma
Initially
Injury-specific support
Protection depends on the exact bone, joint and soft-tissue damage.
During healing
Repeat review
Imaging checks progress; scaphoid union may need CT assessment.
When stability permits
Protected movement
Finger motion and therapy are balanced against the need to protect the fracture or repair.
After confirmed healing
Work & sport progression
Scaphoid non-union and complex trauma can take longer. Return requires a personalised assessment.
07 / RETURN TO LIFE
Back to the things
that matter.
- Work
- Desk duties, tool use and manual work need different levels of grip and safety. Temporary duties may allow earlier return without loading the repair.
- Driving
- A cast, pain, weak grip or medication can impair emergency control. Discuss readiness after review rather than choosing a date from a general timeline.
- Sport & hand therapy
- Movement helps limit stiffness when the fracture is stable enough. Contact sport and heavy lifting require adequate healing and clinical clearance.
08 / RISKS & CONSIDERATIONS
A balanced
decision.
Risks include infection, bleeding, stiffness, tendon irritation or injury, nerve symptoms, loss of alignment and delayed or failed bone healing. Hardware can be troublesome and occasionally needs removal. Joint damage can lead to later arthritis despite treatment. Complex trauma may require more than one procedure.
09 / THE GOAL
Useful function.
Realistic expectations.
The goal is a stable, well-aligned hand or wrist with the best achievable function. The original injury, joint involvement, bone health and rehabilitation affect recovery. Some pain, stiffness or loss of strength can persist.
10 / YOUR QUESTIONS
Before you decide.
Does a fracture always need surgery?
No. Many stable fractures heal with non-operative support. The decision depends on alignment, stability, joint involvement and your needs.
Will plates or screws be removed?
Often they can remain. Removal is considered for a specific reason; temporary wires have their own planned review or removal schedule.
When should I seek urgent help?
A cold, pale or blue finger, worsening numbness, severe escalating pain, an open injury or suspected dislocation needs urgent assessment. Do not repeatedly manipulate a deformity yourself.
CLINICAL READING
Sources & further reading.
General patient guidance to support a consultation. Your own surgical plan and discharge instructions take priority.
- AAOS · Distal radius fractures
- AAOS · Scaphoid fractures
- BSSH · Hand fractures
- BSSH · Distal radius rehabilitation
- Prof. Sami Hassan · What to expect
- Anatomy reference · Distal radius fixation
- Anatomy reference · Scaphoid fixation
- Anatomy reference · Metacarpal fixation
- Anatomy reference · Finger fracture fixation
- Royal College of Anaesthetists · Preparing for surgery
- Chelsea and Westminster Hospital · Before hand surgery
A CONSIDERED NEXT STEP
The right treatment starts
with the right diagnosis.
Understand your options, discuss the trade-offs and plan a recovery that fits your life.
PROF. DR. SAMI HASSAN / HEALTHPOINT