What to expect with upper extremity fracture

Leslie Barnes Remski, M.D.
Orthopaedic Surgeon / Orthopaedic Trauma & Fracture Care Specialist
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 Q: What can a patient expect when they go to the emergency room when they have an upper extremity fracture?
Leslie Barnes Remski, M.D.: What patients can expect when they have an upper extremity injury, which is anything from the collarbone or shoulder down to the fingertips, is that they will be evaluated by an emergency room (ER) physician or another ER provider. They will have an X-ray done, and if there's a fracture identified, either a splint or some sort of stabilization device will be placed. In certain cases, if the injury is more severe and there's a deformity present, a reduction or alignment of the bone may be needed and the ER physician can also do this with or without sedation.
 Q: What are some of the most common upper extremity fractures?
Leslie Barnes Remski, M.D.: The most common upper extremity fractures we see are often around the shoulder involving either the collar bone or the upper part of the arm or proximal humerus, and then very commonly around the wrist and hand. These can happen from fairly minor injuries or falls, so we see them quite frequently, whether it's the smaller bones of the hand or very commonly wrist fractures both in younger and older patients.
 Q: Once a patient does go to the emergency room, when does a patient see an orthopaedic surgeon?
Leslie Barnes Remski, M.D.: Very commonly you’re evaluated and your fracture is identified by an emergency room or an urgent care. At that point, especially if it's an upper extremity injury, which can usually be stabilized either in a splint or a sling, the patient will be sent to an orthopedist or another orthopedic provider. So that that fracture can be treated until it's healed whether that's with surgery or without.
 Q: Talk a little bit about the options patients have when deciding between the ER or urgent care when they have an upper extremity fracture.
Leslie Barnes Remski, M.D.: When patients have an injury you have an option to go to either the ER or to an urgent care. Depending on the severity of the injury if it was a car accident or something with a higher energy, the ER is probably the better place to go. An urgent care is good for somewhat minor injuries where you can still have a fracture, but if there's any deformity of the bone or the joint, then the emergency room is where a reduction or an alignment can be done. The urgent care is a really not ideal for that. So if there's something that really doesn't seem right about your arm or your leg, the emergency room would be the best choice in that case.
 Q: When would it be appropriate for a patient to an urgent care?
Leslie Barnes Remski, M.D.: Typically if you have a minor fall or a twist of your ankle, and you really want to make sure that either don't have fracture and it's just a soft tissue injury or there really isn't a significant deformity but you're pain is there and you want to actually get it evaluated, that would be a really good time to go to urgent care. They can see you're very quickly, they can do X-rays and then send you to the appropriate person. If needed, if there's anything more severe going on and they identify it then they can probably refer you directly to an ER or get you to another kind of provider.


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