You have a broken wrist and the deformity of the wrist needs correcting. This is called a manipulation under anaesthetic and is explained below
You have broken your wrist. Firstly, the deformity of the wrist needs correcting. This is called a manipulation under anaesthetic. Manipulation is a straightforward procedure and you should not feel unduly anxious about it. Afterwards, you will need a plaster cast for about six weeks while the bone sets.
The anaesthetic is given to the arm only, so you are awake for the procedure. The anaesthetic drug is given through a small needle put in a vein in the injured arm. The dose of anaesthetic is calculated for your weight, and the type of anaesthetic used is very safe. Rarely, people can have side effects to the anaesthetic. These might include light-headedness, tingling in the face, or ringing in the ears. These usually only last a few minutes. Your doctor is aware of this and will be able to safely treat any effects you may have. A needle is also put in the uninjured arm in case other drugs need to be given. The drug needs to stay in the arm for about 20–30 minutes, so a tight band or pressure cuff is applied to the top of your arm before the drug is injected. Some people find the pressure cuff uncomfortable to start with.
After the drug is injected, your arm will go pale and blotchy, and after about 10 minutes it is completely numb. The needle is removed once the anaesthetic has worked. You will not feel pain in the wrist when the doctor corrects the deformity.
In some people, even after waiting an extra 5–10 minutes the arm is not numb enough to do the manipulation. In this case your doctor will arrange for another method of anaesthetic. This may require admission for a General Anaesthetic.
After manipulation, a plaster cast is applied and an X-ray is taken. The pressure is not released until the doctor is satisfied with the X-ray. After the cuff is released, it will take about 30–60 minutes for your arm to feel normal again. You may need painkilling tablets once the anaesthetic has worn off. Some people may have some slight bruising to the upper arm when the cuff comes down, despite the use of adequate packing.
Occasionally, it may not be possible to put the break into a position that would allow good healing. In these circumstances, your doctor will arrange a review by the orthopaedic doctors to see if further treatment is advised for your wrist. You will need to rest in the Emergency Department for an hour or two before going home. Over the next day, you should rest at home with someone available to help, if necessary.
The Orthopaedic Doctors will see you in their Fracture Clinic during the following week and your plaster cast may then be completed with a second coat.
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