A broken wrist is among the most common broken bones. In fact, wrist fractures are the most commonly broken bone in patients under 65 years of age (after that age, hip fractures become the most common broken bone).
Usually, when a doctor i describing a wrist fracture, he or she is referring to a fracture of the radius (one of two forearm bones). There are other types of broken bones that occur near the wrist, but a 'wrist fracture' generally means the end of the forearm bone has been broken.
How is the diagnosis of a wrist fracture made?
A wrist fracture should be suspected when a patient injures their wrist joint and has pain in this area. Common symptoms of a wrist fracture include:
Deformity of the wrist
When a patient comes to the emergency room with wrist pain, and evidence of a possibly broken wrist, the first step is to obtain x-rays of the injured area. If there is a broken wrist, the x-rays will be carefully reviewed to determine if the fracture is in proper position, and to assess the stability of the bone fragments.
What is the usual treatment for a wrist fracture?
Most often, broken wrists can be treated in a cast. The wrist is one area of your body that is very amenable to cast treatment. If the bones are out of proper position, then some light sedation or local anesthesia may be used so your doctor can reset the fracture. This is called 'reducing' a wrist fracture, and by performing specific maneuvers, your doctor may be able to realign the broken wrist.
Which wrist fractures need surgery for treatment?
This is a difficult question to answer, and must be addressed on a case by case basis. Even on an individual basis, orthopedists may differ on their opinion of optimal treatment for a given fracture.
Some of the following are important considerations in determining whether or not surgery is necessary for a broken wrist:
Age and physical demands of the patient?If a patient is young and active, every effort will be made to restore the wrist to normal. In some wrist fractures, this may help prevent problems in the years ahead. However, if the patient does not require heavy demands of the wrist, or if the patient is elderly, perfect restoration of the broken bones may not be necessary.
Bone quality?If the bone is severely osteoporotic, then surgery may be less beneficial. If plates and screws are used to fix a fracture, the bone quality must be adequate to secure the screws. Surgery is traumatic to the bone, and sometimes the best course of action is to minimize further insult to the bone and treat in a cast.
Location of the fracture?If the fracture involves the cartilage of the wrist joint, then surgery may be more likely. While bone can remold over time, the cartilage surface of the wrist joint cannot. If the cartilage surfaces are not lined up sufficiently with a reduction (resetting) maneuver, then surgery may be considered.
Displacement of the fracture?If the bones are severely misaligned, then surgery may be performed to properly position the fragments. This is usually attempted without surgery, but it is possible for muscle and tendon to become entrapped and block the resetting. Furthermore, some fractures may be unstable and not stay in position even with a well fit cast. These may need surgery to adequately position the fracture.
Adequacy of non-surgical management?If a fracture is displaced, usually the patient will have an attempted reduction, or repositioning of the broken bone. Sometimes it is difficult to reposition the bones without surgery. Other times, the positioning is satisfactory, but casting may not hold the fracture in that position. Surgery can usually be performed any time in the first two weeks after a fracture to restore the bones to their proper position.
As stated earlier, surgery is not usually needed for a wrist fracture, but it may be considered in some situations. If surgery is performed, there are several options for treatment. Some fractures may be secured with pins to hold the fragments in place. Another option is an external fixator, a device that uses pins through the skin and a device outside the skin to pull the fragments into position. Finally, plates and screws may be used to position the fracture properly.
Fractures and broken bones in Accidents
Kenneth Vercammen & Associates Law Office helps people injured due to the negligence of others. We provide representation throughout New Jersey. The insurance companies will not help. Don't give up! Our Law Office can provide experienced attorney representation if you are injured in an accident and suffer a fracture or broken bone.
Is it a Fracture or a Break?
Despite what you may have heard, a broken bone is not worse than a fracture, they both mean the same thing. In fact, the word fracture, according to the Oxford English Dictionary is defined as the act of being broken. There are different types of fractures and broken bones, but these words mean the same thing!.
Fractures happen because an area of bone is not able to support the energy placed on it (quite obvious, but it becomes more complicated). Therefore, there are two critical factors in determining why a fracture occurs:
* the energy of the event
* the strength of the bone
Treatment of Broken Bones
Bone is constantly in a state of turnover, even when not damaged or injured. We continually absorb and replace the cells that make up our bones. Because of this natural turnover, the process of healing bone also comes about quite naturally.
However, in order for a fracture to heal as well as possible, a good reduction, or placement, of the bones must be attained.
According to http://orthopedics.about.com, when doctors talk about reduction or a fracture, or reducing the broken bone, they are talking about improving the alignment of the broken ends of the bone.
In most cases reducing a fracture involves placing the broken bone in a cast, often after a little pulling and tugging to achieve improved alignment. If the reduction cannot be satisfactorily achieved (meaning the alignment is either not adequate or not sufficiently stable), then a further procedure may be necessary.
This usually means surgery with fixation of the bone with pins, plates, screws or rods.
One potential complication of fracture treatment is either a mal-union or non-union of bone. This problem is more common in elderly individuals and in people who sustain more severe fractures. In the case of some fractures (e.g. hip fracture in elderly) the rate of non-union is high enough that instead of trying to heal the bone, the damaged segment of bone is replaced (e.g. hip replacement). See http://orthopedics.about.com/cs/otherfractures/a/fracture_2.htm
The treatment of a specific fracture is too complicated to be discussed in a general overview of broken bones, but depends on factors such as:
* Location of the fracture
* Severity of angulation or deformity
* Potential for healing
* Other injuries
* Age and activity level of the patient
* And many more factors....
In order to understand your treatment, and the options you may have for treatment, you need to discuss your fracture with your doctor. Because treatments are individualized based on the patient, the x-ray appearance of the fracture, and the other factors mentioned, each case must be treated individually.
The most common cause of fractures is due to trauma.
The following happens in accident cases, both car accidents and fall downs.
Financial Recovery for persons seriously injured in accidents
1. Kenneth Vercammen Helps Injured persons
A person who is injured as a result of the negligence of another person is what we in the legal profession refer to as a personal injury claimant. In other words, they have been injured as a result of an accident, and you now wish to prosecute a claim against an opposing party. As the attorney of record, I can bring an action for the injured person. Therefore, I request that all clients do as much as possible to cooperate and help in every way. The purpose of this article is to describe the procedure that we may follow and give you sufficient instructions to enable you to assist us in this undertaking. Needless to say, helping us is just another way of helping yourself.
2. Clients should provide my office with the following
1. Any bills
2. All Hospital or doctor records in your possession
3. Car Insurance Declaration Sheet if you were in a car accident
4. Car Insurance Policy if car accident
5. Photos of damage to any property
6. Photos of accident site
7. Major Medical Insurance Card
8. Paystub if lost time from work
3. Attorney- Client Confidential Relationship
First, I want to thank our clients for giving me the opportunity to assist them in their case. I am a legal professional and I have great pride and confidence in the legal services that I perform for clients during our relationship as attorney-client. If you have concerns about your case, please call my office at (732) 572-0500.
We feel that this case is extremely important-not only to you, but to this office as well. This is not simply a matter of obtaining just compensation for you, although that is very important. We take professional pride in guiding our clients carefully through difficult times to a satisfactory conclusion of their cases.
4. Submission of Bills to Insurance / Major Medical
If you are in a car accident, you should submit your medical bills to your own car insurance company first. Your car insurance is required by New Jersey law to provide PIP (Personal Injury Protection) benefits under the No Fault Law. This means your car insurance company, not the careless driver, pay the majority of medical bills.
If you do not own a car, but live with someone who owns a car, we can try to help you submit medical bills to their car insurance company.
If this is not a car accident, submit all bills immediately to your major medical.
Please provide car and major medical insurance information to each doctor, MRI facility and treatment provider. Please request they submit bills and attending physician reports to car insurance and major medical. There is now minimum deductibles under the PIP Law. There is an initial $250.00 deductible, and thereafter your car insurance company pays 80% of medical bills under a medical fee schedule established by the State Dept. of Insurance. Your primary treating doctor must also follow Care Path. Submit portions of bills the car insurance does not pay to your major medical carrier (ex- Blue Cross, Connecticut General). The Law Office of Kenneth Vercammen can provide a more detailed brochure explaining how car insurance works.
Never give a signed statement to the claims adjuster representing the other driver's insurance company. The same goes for a phone recording. They may be used against you in court to deny your claim. Speak with your personal injury attorney first.
WHILE YOUR PERSONAL INJURY CASE IS PENDING:
It is important that you --
1. DO NOT discuss your case with anyone except your doctors and attorney.
2. DO NOT make any statements or give out any information.
3. DO NOT sign any statements, reports, forms or papers of any kinds.
4. DO NOT appear at police or other hearings without first consulting with your attorney.
INFORM YOUR ATTORNEY PROMPTLY of any notice, request or summons to appear at any such hearings.
5. Refer to your attorney, anyone who asks you to sign anything or to make any statement or report or who seeks information concerning your case.
6. Direct your doctor and other treatment providers not to furnish or disclose any information concerning your case to any entity other than your insurance company without YOU AND YOUR ATTORNEY'S WRITTEN PERMISSION.
7. You may have insurance coverages such as liability, collision, accident, Blue Cross, Blue Shield or Major Medical which require prompt attention. However, be sure to have your treatment providers send bills immediately to all of your insurance companies.
8. Notify your attorney promptly of any new developments. Small things may be important. Keep your attorney informed.
9. Maintain accurate records of all information and data pertaining to your case.
10. If you or any witnesses should move, be sure to notify your attorney of the new address.
We want you to keep a diary of your experiences since your accident. In addition to this daily record, we also ask you to start describing a single day in the course of your life. In other words, describe what you do when you get up in the morning, the first thing you do after you go to work, what type of work and effort you put into your employment, what activities you engage in after work, etc. In other words, we need you to describe the changes in your working life, your playing life, your life as a husband or wife or child or parent. In your written description of your day, we would appreciate your explanation in the greatest detail possible and in your own words how the accident and subsequent injuries have affected your life, your personality, and your outlook. And remember that suffering does not entail mere physical pain; suffering can be emotional and can be transmitted to your family, friends, and co-workers. When you have completed this description, please return it to this office in the enclosed envelope.
Keep a diary of all matters concerning this accident-no matter how trivial you think it may be. You should include notes on the treatments you receive, therapy, casts, appliances, hospitalization, change of doctors, change of medication, symptoms, recurrence, setbacks, disabilities and inconveniences. If you have any doubt about the propriety of including some particular information, please call the office and let us assist you.
6. Record expenses
You can also begin to set up a system for recording the expenses incurred in conjunction with your claim in minute detail. Medical and legal expenses are a strong part of the value of your lawsuit, so good records of these expenses must be kept at all times.
From time to time, however, there will be expenses incurred that you must keep track of yourself. We ask you to make every effort to avoid any possible error or inaccuracy as jurors have a relentless reverence for the truth. Keep your canceled checks and your list of expenses together, for we will need them at a later date.
Your attorney will keep track of your legal expenses, which may include costs of filing, service of process, investigation, reports, depositions, witness fees, jury fees, etc.
7. Investigation and Filing of Civil Complaint in Superior Court
Procedurally, the following events occur in most personal injury cases. First, your attorney must complete our investigation and file. This will involve the collection of information from your physician, your employer, and our investigator. We will need your Doctors to provide us with copies of all bills, medical records and possibly a medical report.
When we feel that we have sufficient information to form an opinion as to the financial extent of your damages, we will commence negotiations with the opposition for a settlement. If the insurance company will not make an adequate offer, then a Complaint and Case Information Statement is prepared by your attorney. It is filed in the Superior Court, Law Division. Your attorney then will prepare a summons and have the defendants personally served with the Summons and Complaint. The defendant, through their insurance company, must file an Answer within 35 days.
8. Interrogatory Questions and Discovery
The Answer is followed by a request for written interrogatories. These are questions that must be answered by each party. The Superior Court has set up certain Form Interrogatories which are contained in the Rules of Court. Generally, written interrogatories are followed by the taking of depositions, which is recorded testimony given under oath by any person the opposition wishes to question. The deposition is just as important as the trial itself. In the event you are deposed during the course of this action, you will receive detailed instructions as to the procedure and will be requested to watch a videotape. After taking depositions, the case will be set down for an Arbitration. If the parties do not settle after the Arbitration, the case will be given a trial call date.
Altogether, these procedures may take from six months to several years, and your patience may be sorely tried during this time. However, it has been our experience that clients who are forewarned have a much higher tolerance level for the slowly turning wheels of justice.
9. Doctor/ Treatment
It will help your case to tell us and your doctors about any injury or medical problems before or after your accident. Good cases can be lost by the injured person's concealing or forgetting an earlier or later injury or medical problem. Insurance companies keep a record of any and all claims against any insurance company. The insurance company is sure to find out if you have ever made a previous claim.
Tell your doctors all of your complaints. The doctor's records can only be as complete as what you have given. Keep track of all prescriptions and medicines taken accompanied by the bills. Also save all bottles or containers of medicine.
Retain all bills which relate to your damages, including medical expenses, hospital expenses, drugs and medicines, therapy, appliances, and anything needed to assist you in your recovery. If possible, pay these bills by check or money order, so that a complete record may be kept. If this is not possible, be certain to obtain a complete receipt with the bill heading on it, to indicate where the receipt came from and the party issuing it.
Be certain to keep anything that comes into your possession which might be used as evidence in your case, such as shoes, clothing, glasses, photographs, defective machinery, defective parts, foreign substances which may have been a factor in your accident, etc. Be sure to let the office know that you have these items in your possession.
Take photographs of all motor vehicles, accident site, etc., that may be connected directly or indirectly with your accident. Again, be sure to let the office know that you have such photographs.
13. Keep your attorney advised
Keep this office advised at all times with respect to changes in address, important changes in medical treatment, termination of treatment, termination of employment, resumption of employment, or any other unusual change in your life.
14. Lost wages
Keep a complete record of all lost wages. Obtain a statement from your company outlining the time you have lost, the rate of salary you are paid, the hours you work per week, your average weekly salary, and any losses suffered as a result of this accident. Where possible, also obtain other types of evidence such as ledger sheets, copies of time cards, canceled checks, check stubs, vouchers, pay slips, etc.
15. New information
In the event that any new information concerning the evidence in this case comes to your attention, report this to the Attorney immediately. This is particularly true in the case of witnesses who have heretofore been unavailable.
16. Do not discuss the case
The insurance company may telephone you and record the conversation or send an adjuster (investigator) who may carry a concealed tape recorder. You should not discuss your case with anyone.
Obviously, we cannot stress too strongly that you DO NOT discuss this matter with anyone but your attorney or immediate, trusted family. You should sign no documents without the consent of this office. Remember that at all times you may be photographed and investigated by the opposition. If you follow the simple precautions which we have set out in your checklist, we feel that we will be able to obtain a fair and appropriate amount for your injuries. If you get any letters from anyone in connection with your case, mail or fax them to your attorney immediately.
If any person approaches you with respect to this accident without your attorney's permission, make complete notes regarding the incident. These notes should include the name and address of the party, a description of the person, and a narrative description of what was said or done. Under no circumstances should you answer any question(s). All questions should be referred to your attorney's office.
18. Investigation by Defendant Insurance Company
Permit us to reiterate at this time that the opposition's insurance company will in all probability have a team of lawyers and investigators working diligently to counter your claim. During the course of their investigation, it is quite possible that they may attempt to contact you through various (and sometimes, devious) methods. Please do not make their jobs any easier for them by answering their questions.
We cannot emphasize too strongly that you should refrain at all times from discussing this matter with anyone--and that includes your employer, your relatives, your neighbors, and even your friends. Of course, there are exceptions to this rule.
If there are friends or neighbors or relatives who know all of the facts and circumstances surrounding the accident and can be of assistance to you, then they should be referred to this office so that their natural sympathy can be channeled into an effective asset for you.
Insurance companies pay money to claimants when they are satisfied there are both liability and damages that support a recovery. They can be expected to thoroughly investigate the facts of the accident and any past injuries or claims. The insurance company will obtain copies of all of the claimant's past medical records.
19. The value of a case depends on the Permanent Injury, medical treatment and doctor's reports
Undoubtedly, you have questions as to how much your case is worth. We are going to be frank: The fact of the matter is there can be no answer to this question until we have completed the investigation in your case. Once we complete our investigation, of course, we can make a determination as to the amount of the defendant's liability, if any, and even at that we will only be at a starting point. After that, we must obtain all necessary information concerning your lost wages, your disability, your partial disability, your life changes, and your prognosis. You may rest assured of one thing, however, and that is the fact that your case will not be settled below its true value, that is the fair compensation for the injuries you have received. You may also rest assured that no settlement agreement will be entered into without your consent.
We appreciate that this is a great deal of information to absorb. We also appreciate that our requests for client's assistance have been numerous. However, we are certain that our clients appreciate having this information from the outset. Each request and bit of information given here represents an important part in recovering full value for your injury. Therefore, we respectfully request your full cooperation. If you have questions or concerns regarding these instructions, we encourage you to feel free to contact the office at any time.
CALL KENNETH A. VERCAMMEN, ESQ. 732-572-0500 for an appointment
About Kenneth Vercammen:
Kenneth Vercammen is a Litigation Attorney in Edison, NJ, approximately 17 miles north of Princeton. He often lectures for the New Jersey State Bar Association on personal injury, criminal / municipal court law and drunk driving. He has published 125 articles in national and New Jersey publications on municipal court and litigation topics. He has served as a Special Acting Prosecutor in seven different cities and towns in New Jersey and also successfully defended hundreds of individuals facing Municipal Court and Criminal Court charges.
In his private practice, he has devoted a substantial portion of his professional time to the preparation and trial of litigated matters. He has appeared in Courts throughout New Jersey several times each week on many personal injury matters, Municipal Court trials, matrimonial hearings and contested administrative law hearings.
Since 1985, his primary concentration has been on litigation matters. Mr. Vercammen gained other legal experiences as the Confidential Law Clerk to the Court of Appeals of Maryland (Supreme Court), with the Delaware County, PA District Attorney Office handling Probable Cause Hearings, Middlesex County Probation Dept. as a Probation Officer, and an Executive Assistant to Scranton District Magistrate Thomas Hart in Scranton, PA.
KENNETH VERCAMMEN & ASSOCIATES, PC
ATTORNEY AT LAW
2053 Woodbridge Ave.
Edison, NJ 08817