Justin Turner's Wrist Fracture
Justin Turner was struck by a pitch in his left wrist during a spring training game against the Oakland A's. X-ray confirmed a non-displaced wrist fracture. The injury is to his non-dominant, non throwing left hand. Based on early reports his fracture is minor and will not need surgery. Furthermore, his return to play will likely be fairly short due to the fact that he can be put in a protective brace to participate in fielding activities. Return to batting may be delayed based on pain. Possibilities of minor fractures that he could have include a non displaced fracture of the distal radius (below), buckle fracture of the ulna (below)or ulna styloid fracture (above). Depending upon the extent of the fracture I think it is possible we could see his return in about 4 weeks.
Distal Radius Fracture
Below is an AP (Frontal) of a distal radius fracture. Note that ideally a medical provider needs at least two different views to make an accurate diagnosis. The fracture shown below is a classic non-displaced distal radius fracture of the wrist.
Buckle Fracture of ULNA
Below is a (side view) of a distal ulna buckle fracture. The medical provider needs to pay close attention to note a buckle fracture as they may be easily missed. A very tiny buckle fracture, is represented as a dent or depression in the outer surface of the bone.
The treatment depends on a few key aspects of the fracture. In adult patients, a few important factor include if the fracture is displaced or angulated as well as if the fracture involves the joint surface. Non-operative treatment typically consists of a short arm cast (below the elbow) or if the fracture is minor a simple wrist brace. Length of treatment is usually 4 weeks. In adults, surgery is recommended with significant displacement or angulation of the fracture or if the fracture fragments are separated more than 2mm in the joint surface. Additionally, surgery is required when the bone is sticking out of the skin, which is called an open fracture. Surgery may consist of adjusting the bone with the patient asleep and casting or using pins or plates to stabilize the fracture.
Functional Wrist Brace
Return TO PLAY
Return to play after a fracture varies significantly based on the severity of the fracture and the sport of the individual. With a buckle fracture, full return to activity with protective brace or cast can be appropriate for sports such as cross-country or soccer. With more significant fractures, sports should be restricted until the medical provider feels that the fracture is stable and the risk of shifting is minimal. At that time, it may be acceptable to return an athlete to play with the cast and appropriate padding to protect other athletes.
Under certain circumstances an athlete may be able to play with a fractured wrist with the appropriate protection. As expected, this will vary among medical providers and is multi-factorial. Additionally, if the athlete is cleared they will have to provide appropriate padding to the cast or brace to protect others against injury. Additionally, the athlete will have to get permission from whichever league they are participating in so the proper documentation can occur.