Jock Doc

Broken wrist doesn’t always need a cast

Q. Last week my girlfriend fell while rollerblading and broke her wrist. At the emergency room, doctors told her she needed surgery as the bone was out of place. The doctor did surgery and she had a plate and screws put in her wrist. She is in a splint and still in a lot of pain. She is supposed to start physical therapy next week. I do not understand why the break wasn't set and put in a cast instead. Was this the right treatment?

A.When I was training to be an orthopedic surgeon, wrist fractures were treated with putting the fracture back in place followed by casting for two to three months. Casts are still used for many non-displaced fractures. However, advances in the last decade have led to much better results for most displaced wrist fractures treated with surgery. Surgery usually involves putting the bones back into place (anatomic alignment) and holding them with special metal plates and screws. This allows for an early rehab program with a physical or occupational therapist. This approach frequently results in a better, more functional result.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send questions to