How to treat a hand fracture in a hypertensive patient?

Question

Hello doctor,

I am attaching the X-ray reports of my sister-in-law, whose hand has been fractured. She has HTN. Kindly suggest the protocol she needs to follow step by step.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen (attachment removed to protect the patient's identity) the X-ray reports. She has a fracture of the lower end of the radius just above the wrist, which is displaced with a tilt. I suggest a closed reduction and a below elbow plaster slab for one week. Repeat X-ray after one week. If the position is good, convert it to a plaster cast. Keep it for weeks. Remove it after five weeks. Take one more X-ray to see if it has united. Then do ten days of physiotherapy at home for regaining motion. She should return to normal two months after the fracture. If an X-ray after one week shows displacement, she will need surgery with a plate and screws. Another option would be surgery now itself. Then she would not need plaster, can start moving her wrist in seven days, and will not need physiotherapy. It will still take six weeks for the bone to join.

Thank you.