Shoulder · Elbow · Wrist · Hand
Fracture Surgery
Broken bones and upper-extremity injuries can affect movement, strength and long-term joint function. Precision Hand and Orthopedic Surgery evaluates and treats fractures involving the shoulder, elbow, wrist and hand, including injuries that may require surgical fixation.
(623) 264-3300What Fixation Actually Does
Surgery does not heal the bone — your body does that. Fixation creates the conditions for it to happen correctly.
Restores Alignment
Puts the fragments back where they belong so the bone heals in a useful position.
Holds It There
Hardware maintains that position through weeks of healing that a cast cannot guarantee.
Protects the Joint Surface
Rebuilding a smooth cartilage surface reduces the risk of arthritis later.
Allows Earlier Motion
Stable fixation often permits movement sooner, which helps prevent stiffness.
The Decision
When a Fracture Needs an Operation
Many fractures heal well in a cast or splint. Surgery is recommended when the characteristics of the break make that unlikely, or when the consequences of healing out of position would be significant.
The Bone Is Displaced
If the fragments have shifted out of position and cannot be held in alignment with a cast or splint, surgery restores and maintains the anatomy.
The Joint Surface Is Involved
A step-off in the cartilage surface of a joint can lead to arthritis later. Restoring a smooth joint surface is a common reason to operate.
The Fracture Is Unstable
Some fracture patterns will not hold their position no matter how well they are splinted. These are better served by internal fixation.
A Bone Is at Risk of Not Healing
Certain fractures — the scaphoid in particular — have a tenuous blood supply and a real risk of nonunion if not treated appropriately.
The Injury Is Open
A fracture with a break in the skin requires timely surgical cleaning and stabilization.
Function Is Compromised
Rotation, shortening or angulation that would interfere with how the hand or arm works is corrected surgically.
Why Follow-Up Imaging Matters
A fracture that looks acceptable on the first X-ray can shift position over the following one to two weeks as swelling resolves. Repeat imaging catches that early, while the fracture is still easier to manage. This is one reason a fracture treated without surgery still needs a follow-up plan rather than a single visit.
By Region
Fractures Treated From Shoulder to Fingertip
The bone that is broken determines almost everything about how it is treated — how much displacement is acceptable, how long it takes to heal, and how quickly motion can start.
Shoulder Fractures
Proximal humerus fractures near the shoulder joint. Many can be treated in a sling with early gentle motion; displaced or unstable fractures may require plates and screws or, in selected cases, shoulder replacement.
Elbow Fractures
Fractures of the distal humerus, radial head and olecranon. The elbow is unforgiving of prolonged stiffness, so restoring alignment and starting motion early is often the priority.
Wrist Fractures
Distal radius and scaphoid fractures are the most common. Alignment, joint surface and the healing potential of the scaphoid all factor into whether surgery is recommended.
Hand & Finger Fractures
Metacarpal and phalanx fractures. The position of the fingers matters for grip, so rotation and shortening are corrected when they would affect how the hand closes.
Techniques
How Fractures Are Held Together
Different fracture patterns call for different hardware. The choice is driven by the bone, the location of the break, the size of the fragments and how much load the area has to carry.
Plates & Screws
The workhorse of fracture fixation. A plate spans the fracture and screws anchor it to the bone on either side, holding alignment rigidly while it heals.
Kirschner Wires & Screws
Thin wires or individual screws, often used in small bones of the hand and wrist where a plate would be too bulky.
External Fixation
A frame outside the limb holds the fragments in place through pins. Used when the soft tissue envelope needs to be protected.
About the Hardware
Does it stay in?
Usually, yes. Most plates and screws remain permanently. Hardware is removed only if it becomes prominent, painful or interferes with a tendon.
Can it break?
Hardware can fatigue or loosen, particularly if the fracture does not heal. Follow-up imaging tracks both the bone and the implant.
Will I feel it?
Some patients can feel a plate under thin skin, especially around the wrist or ankle. This is common and often not a problem.
Risks & Benefits
Outcomes after surgery vary, and risks and benefits should be discussed in detail with your treating physician. Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
Common Questions
Fracture Surgery FAQs
How do I know if my fracture needs surgery?+
The decision depends on the bone involved, how far out of position the fragments are, whether the joint surface is involved, and whether the fracture pattern is stable enough to hold with a cast or splint. Some fractures that initially look like they can be treated without surgery displace over the following weeks and end up needing an operation. That is why follow-up X-rays matter even when the first one looks acceptable.
What is internal fixation?+
Internal fixation means using hardware implanted inside the body — typically plates and screws, or occasionally pins or wires — to hold the pieces of a broken bone in the correct position while they heal. The hardware usually stays in place permanently, though it can be removed later if it becomes symptomatic.
Will the hardware set off metal detectors?+
Plates and screws used in orthopedic surgery are generally made of titanium or stainless steel. Small implants in the hand, wrist and elbow rarely trigger airport security, though you can mention it if you are asked to walk through a scanner. Larger shoulder implants are more likely to be noticed.
Why does a scaphoid fracture get treated so carefully?+
The scaphoid is a small bone in the wrist with a blood supply that enters at one end and travels the length of the bone. A fracture through the middle can interrupt that supply to the far fragment, which puts the bone at risk of not healing or of losing its blood supply. Because the consequences of a missed scaphoid fracture are significant, these injuries are treated with a low threshold for surgery or prolonged immobilization.
How long does a broken bone take to heal?+
Most upper-extremity fractures take roughly six to twelve weeks to heal solidly, though this varies by bone, by fracture pattern, by age and by other medical factors. Clinical healing — being able to use the limb — often precedes full radiographic healing. Your surgeon will track your progress with follow-up imaging.
Can stiffness be prevented after a fracture?+
Stiffness is one of the most common problems after an upper-extremity fracture, particularly around the elbow. The best defense is a plan that starts controlled motion as soon as it is safe for the particular fracture, frequently with the guidance of a hand or physical therapist. This is why the treatment plan addresses motion, not just the bone.
Injured? Get the Right Orthopedic Care.
If you have a suspected fracture of the shoulder, elbow, wrist or hand, an evaluation establishes what is broken and how it should be treated — including whether surgery is needed.