The management of wrist injuries: an international perspective

Wrist injury is common and may significantly impair the overall function of the upper extremity unless properly managed. Fractures of the distal radius are particularly common among the aging population, accounting for nearly 1/6 of all fractures, often as a result of increased longevity with the subsequent underlying osteoporosis. New diagnostic tools, including wrist arthroscopy, magnetic resonance imaging, or computed tomography, are increasingly available in developed countries allowing accurate recognition and more effective resolution of lesions which would be otherwise missed using conventional methods. First world treatment standards, however, can scarcely be introduced in developing countries owing to, among other factors, different prevalence of problems, and the lack of resource to implement most modern technologies. If any program needs to be introduced that meets the demands of wrist injury management in the third world, aside from a better regionalisation of trauma care, it should emphasise adequate training of professionals in the use of more cost effective techniques of fracture reduction and stabilisation, applicable everywhere, with the minimum possible morbidity.