In this episode of The Good GP Podcast, host Dr Tim Koh is joined by Dr Jeff Ecker, an experienced orthopaedic surgeon based in Perth with over 35 years of expertise in complex hand and wrist conditions. Discussing the assessment and management of wrist fractures, with advice tailored for general practitioners.

Exploring the most common wrist fractures encountered in general practice, particularly among older adults after low-energy falls. Dr Ecker emphasises a careful history and examination, and attention to associated injuries to the elbow and shoulder. He also discusses the challenges of seemingly minor wrist injuries in younger patients and the need for an accurate and early diagnosis to prevent complications such as non-union and advanced arthritis.

Reviewing imaging strategies, with recommendations on when to use plain X-rays, CT scans, or MRIs based on clinical suspicion and fracture characteristics. Dr Ecker calls attention to the limitations of MRI, especially in detecting ligamentous wrist injuries, and the need for ongoing clinical vigilance.

They also talked about management principles for minimally displaced wrist fractures, and the practical use of back slabs, thermoplastic splints, ensuring proper hand function throughout immobilisation. 

Effective analgesia choices and the critical role of rehabilitation in preventing stiffness and chronic pain syndromes were also discussed. Concluding with practical considerations for managing wrist fractures in aged care settings, reinforcing the need for individualised assessment and the avoidance of age-related bias in treatment planning.

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