Dr. Francisco del Piñal, head of the Hand Surgery and Microsurgery Unit at the Vithas Madrid La Milagrosa Hospital, warns of the importance of a good clinical approach to these breaks to avoid serious sequelae, such as continuous pain, loss of mobility or lack of strength

According to the specialist, some patients need a second precision surgery that favors their definitive incorporation into routine life

Radius fracture is one of the most frequent injuries among the population. Specifically, it accounts for up to 25% of all breaks and 75% of wrist breaks. As explained by Dr. Francisco del Piñal, head of the Hand Surgery and Microsurgery Unit at Vithas Madrid La Milagrosa Hospital, “they are inherent to our own vital activity. In the case of children and young people, they are high-energy fractures, that is, the trauma is caused by traffic accidents, sports injuries, falls from a height…”.

As the patient ages, wrist fractures are influenced by “other low-energy mechanisms, such as small slips, as well as bone degeneration processes, such as osteoporosis.” In addition, according to the doctor, these injuries have their origin in a misalignment of the joint or the bone: “Either of the two things will cause the wrist to not work in optimal conditions. This joint, especially in the dominant hand, must be in perfect condition to meet our daily needs”, he explains.

Sometimes, incorrect treatment of radius fractures, either by casting or other procedures, can lead to “serious sequelae, such as continuous pain, loss of mobility or lack of strength.” Of the total number of patients that Dr. Piñal receives in his consultation, around 20% suffer from one of these complications: “This data is not simple statistics, since, unlike an acute fracture, which can be easy to treat, in a sequel it is more complex to achieve a perfect result”.

In this sense, he assures that, “after two or three days of treatment or operation on a fractured wrist, there should be no pain, mobility should improve quickly and there is no room for swollen fingers, with tingling or clicking; among other annoyances.

The dry arthroscopy technique

Only in wrist fractures, Dr. Piñal performs more than 150 interventions a year. He was the first surgeon in the world to describe and apply dry arthroscopy, a type of non-invasive technique that “improves the chances of success by eliminating the need to inject fluids into the affected area.” This procedure, in addition, “allows to identify, that is, to establish the cause of situations of discomfort and wrist pain that escape other diagnostic formulas, such as resonance, electromyogram or CT”, he details.

According to the specialist, the advantages of arthroscopy over conventional surgery are fundamentally three: “It minimizes the risk for the patient, requiring only local or locoregional anesthesia; it reduces the aesthetic impact, that is, the incisions are minimal, hardly leaving a scar, and it reduces recovery time”.

‘Atlas of Distal Radius Fractures’, translated into Chinese

Considered one of the best hand surgeons in the world, Dr. Piñal is the author, to date, of four books on his specialty. Among them stands out ‘Atlas of distal radius fractures’. With a practical approach and over almost 400 pages, 700 illustrations, intraoperative photographs and surgical videos commented by the specialist, it is a comprehensive guide for the diagnosis, treatment and surgery of this type of fracture.

The book also places special emphasis on the possible complications that hand and wrist surgeons may face in the operating room. This atlas is addressed to them, as well as to orthopedic and plastic surgeons, both specialists and subspecialists. In 2018, the specialized publisher Shanghai Scientific and Technical Publishers launched the Chinese version of this work, which represents a milestone in the Spanish medical literature in the field of traumatology.