Wrist Conditions Treated at OAIC Peshawar

🦴 Hand & Wrist Surgery Specialist — Peshawar

Wrist Fracture & Wrist Pain Treatment in Peshawar

The distal radius is the most commonly fractured bone in the human body, and the wrist is home to some of the most frequently mismanaged injuries in KPK — from scaphoid fractures missed on a “normal” X-ray to carpal tunnel symptoms dismissed as uric acid. At OAIC, every wrist injury is assessed against the specific fracture pattern, ligament, or nerve involved, not treated as one generic “wrist sprain.”

Signs Your Wrist Needs a Proper Assessment

Wrist pain that persists for weeks after a fall, even with a "normal" X-ray
A wrist that healed "bent" or deformed after an old fracture
A lump or swelling on the wrist that comes and goes
Numbness or tingling in the thumb, index, and middle fingers — worse at night
Pain on the little-finger side of the wrist when gripping or twisting the forearm
Chronic wrist stiffness and weakness years after an old, untreated injury

The Basics

The Wrist Is Not One Joint — It's a Complex of Eight Small Bones

The wrist links the forearm to the hand through eight carpal bones, a network of stabilising ligaments, the median nerve, and the TFCC cartilage complex. A “wrist injury” can mean a fracture, a torn ligament, a compressed nerve, or all three together — which is exactly why a single X-ray and a generic diagnosis so often misses the real problem.

The Local Challenge

Why Wrist Injuries Are Systematically Undertreated in KPK

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Normal X-ray ≠ No Fracture

Scaphoid fractures and hairline distal radius fractures are frequently invisible on initial plain X-rays, leading to a “sprain” diagnosis on a genuinely broken bone.

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Displacement Needs Measurement

Radial inclination, height, and tilt determine if a fracture will hold in a cast — measurements not routinely performed in busy emergency departments.

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Conservative Default, Not Assessment

Casting every wrist fracture by default — rather than assessing surgical thresholds — produces malunions and non-unions that fixation would have prevented.

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CTS Blamed on Other Conditions

Hand numbness is attributed to cervical spine disease, diabetes, or “uric acid,” without the nerve conduction study that identifies the true cause.

Inside the Wrist

Wrist Conditions Treated at OAIC Peshawar

Each wrist problem has a distinct cause, risk, and treatment threshold.

Most Common Fracture

Distal Radius Fractures

From the classic Colles’ “dinner-fork” deformity to intra-articular and comminuted patterns. Surgery with a volar locking plate is indicated for displaced, unstable, or joint-surface fractures.

Most Often Missed

Scaphoid Fractures

Invisible on X-ray in 15–20% of cases. Left untreated, the precarious blood supply fails, causing avascular necrosis, non-union, and progressive SNAC wrist arthritis.

Most Common Nerve Compression

Carpal Tunnel Syndrome

Median nerve compression causing night-time numbness in the thumb, index, and middle fingers. Highly treatable with splinting, injection, or a 20–30 minute release procedure.

Ulnar-Sided Pain

TFCC Injuries

Cartilage and ligament tears on the little-finger side of the wrist, worsened by gripping and forearm rotation. Diagnosed with MRI; treated arthroscopically or with splinting.

Routinely Missed on X-ray

Wrist Ligament Injuries

Scapholunate and lunotriquetral ligament tears cause progressive instability — untreated, the wrist collapses into the SLAC arthritis pattern over years.

Most Common Swelling

Ganglion Cysts

Benign, fluid-filled cysts accounting for 60–70% of wrist lumps. Most need no treatment; surgical excision with root removal prevents recurrence when symptomatic.

End-Stage Joint Damage

Wrist Arthritis & Reconstruction

From SNAC or SLAC collapse. Treated with partial wrist fusion (preserving motion), total fusion, or — in selected low-demand patients — wrist replacement.

Paediatric Priority

Wrist Fractures in Children

The most common childhood fracture in KPK. Growth-plate involvement is specifically assessed to prevent deformity that can appear years after healing.

What To Look For

Specific Clinical Signs Worth Recognising

Classic Sign

🍴 Dinner-Fork Deformity

The visible upward tilt of a displaced Colles’ fracture — the textbook sign of a distal radius fracture.

Hallmark

🤚 The Flick Sign

Shaking the hand for temporary relief from numbness — a classic carpal tunnel syndrome feature, often dismissed by patients as a habit.

Diagnostic Clue

👆 Snuffbox Tenderness

Tenderness in the hollow on the thumb side of the wrist after a fall — the key clinical sign that should trigger scaphoid imaging.

Radiological Sign

📏 The Terry Thomas Sign

Widening of the gap between the scaphoid and lunate on stress X-rays — confirms scapholunate ligament tear.

Serious

⚠️ Thenar Wasting

Wasting of the thumb-base muscle in advanced carpal tunnel syndrome — represents permanent nerve damage that surgery can halt but not fully reverse.

Progressive

🦴 SNAC / SLAC Collapse

The predictable arthritis pattern that follows an untreated scaphoid non-union or ligament tear — preventable with early diagnosis.

The Process

How Wrist Injuries Are Diagnosed at OAIC Peshawar

A normal X-ray is the start of the assessment, not the end of it.

1 Clinical Examination

Snuffbox tenderness, deformity, nerve distribution, and ligament stress testing.

2 Plain X-ray

First-line imaging — but a normal result does not exclude fracture or ligament injury.

3 CT / MRI

Ordered when clinical suspicion remains despite a normal or equivocal X-ray.

4 Stress Views / Nerve Studies

Stress X-rays confirm ligament instability; nerve conduction studies confirm and grade carpal tunnel syndrome.

Investigation	What It Tells Us
Plain X-ray	First-line view; misses scaphoid fractures in roughly 15–20% of cases at the time of injury
CT Scan	Confirms or excludes a fracture when X-rays are equivocal or normal
MRI	Most sensitive for occult fractures, bone oedema, TFCC tears, and ligament injuries
Stress X-rays	Reveals scapholunate gap widening (Terry Thomas sign) in ligament instability
Nerve Conduction Study	Confirms carpal tunnel syndrome and grades its severity

Management

Treatment of Wrist Conditions at OAIC Peshawar

Gold-standard fixation for displaced distal radius fractures, allowing early wrist movement.

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Volar Locking Plate

Gold-standard fixation for displaced distal radius fractures, allowing early wrist movement.

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Headless Compression Screw

Stable scaphoid fixation, with bone grafting added for established non-unions.

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Carpal Tunnel Release

A 20–30 minute day-case procedure that decompresses the median nerve.

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TFCC Repair / Debridement

Arthroscopic repair for peripheral tears; debridement for central, degenerative tears.

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Ligament Repair & Reconstruction

Stabilises acute or chronic scapholunate instability before arthritis develops.

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Ganglion Excision

Root removal from the joint capsule to minimise recurrence.

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Partial / Total Wrist Fusion

Eliminates arthritic joint surfaces in advanced SNAC or SLAC wrist, preserving function and grip strength.

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Total Wrist Replacement

Selected for low-demand patients wanting pain relief with some preserved motion.

Don't Mistake a Normal X-ray for "No Injury"

A clear X-ray rules out an obvious fracture — it does not rule out a wrist problem. These signs need further assessment regardless of the X-ray report:

Still Concerning Despite a Normal X-ray

Needs More Than a Wrist Splint

Don't Wait Years to Get This Assessed

Why OAIC

Why Patients Across KPK Choose OAIC for Wrist Surgery

🎓 FCPS · FRCS UK · FACS

Three of the most rigorous postgraduate surgical qualifications in Pakistan, the UK, and the USA.

🦴 Ilizarov & External Fixation Expertise

Specific capability for complex wrist and forearm fractures needing bridging fixation or distraction.

🩻 Assessment Beyond the Plain X-ray

CT and MRI ordered whenever clinical suspicion outweighs a normal X-ray — no default “sprain” diagnosis.

🔧 Non-Union & Malunion Correction

Tertiary capability for scaphoid non-unions, malunited fractures, and missed ligament injuries.

⚡ Day-Case Surgery

Carpal tunnel release, ganglion excision, and K-wire fixation performed as day cases with rapid rehab.

📍 Serving All of KPK

Patients from Peshawar, Charsadda, Mardan, Nowshera, Swabi, Dir, and Swat — without travelling to Lahore.

Main Clinic — Peshawar

Akbar Medical Centre

Address:Clinic 311A, Third Floor, Akbar Medical Centre, Peshawar

Days:Monday – Friday

Hours:4:00 PM – 7:30 PM

Sunday:12:00 PM – 4:00 PM

Charsadda

Haleem Medical Centre

Address:Peshawar Road, Charsadda

Days:Saturday

Hours:9:00 AM – 7:00 PM

Hospital OPD

Lady Reading Hospital MTI

Address:Department of Orthopaedics, LRH MTI, Peshawar

Phone:091-9211430

For complex fractures and surgical procedures requiring hospital facilities.

Frequently Asked Questions

Q 1 Who is the best wrist surgeon in Peshawar?

Dr Muhammad Inam Khan at OAIC holds FCPS, FRCS (UK), and FACS. He performs the full range of wrist surgical procedures at Lady Reading Hospital MTI, including distal radius fracture fixation, scaphoid surgery, carpal tunnel release, TFCC repair, and wrist arthritis reconstruction. He consults at Akbar Medical Centre, Peshawar, Monday to Friday from 4:00 PM.

Q 2 I fell and hurt my wrist — does it need surgery?

Not every wrist injury requires surgery. The decision depends on the fracture, its displacement and stability, and the patient’s age and functional demands. The critical first step is accurate diagnosis — clinical assessment, alignment measurements, and CT or MRI when X-rays are equivocal — which determines the correct treatment pathway.

Q 3 My wrist X-ray was normal but it still hurts — what should I do?

Persistent wrist pain after a fall with a normal X-ray warrants further investigation, not reassurance. Scaphoid fractures are invisible on initial X-ray in roughly 15–20% of cases, and TFCC tears, ligament injuries, and osteochondral injuries are not visible on plain X-ray at all. A CT or MRI provides the diagnosis the X-ray missed.

Q 4 What is carpal tunnel syndrome and how is it treated in Peshawar?

Carpal tunnel syndrome is compression of the median nerve at the wrist, causing numbness and tingling in the thumb, index, and middle fingers — worst at night. Early and moderate disease responds to night splinting, treatment of underlying conditions, and corticosteroid injection. Severe disease requires carpal tunnel release — a 20–30 minute day-case procedure performed at OAIC under local or regional anaesthesia.

Q 5 Is wrist surgery available in Peshawar?

Yes. The full range of wrist surgical procedures — distal radius fracture fixation, scaphoid fixation and bone grafting, carpal tunnel release, TFCC repair, ganglion excision, and wrist arthritis reconstruction — is performed at OAIC by Dr Muhammad Inam Khan at Lady Reading Hospital MTI, Peshawar, without needing to travel to Lahore or Islamabad.

Q 6 What is a scaphoid fracture and why is it dangerous if missed?

The scaphoid is a small bone on the thumb side of the wrist and the most commonly missed fracture in orthopaedics, often invisible on initial X-rays. If missed, the bone’s blood supply is disrupted, causing avascular necrosis and non-union — and over years, the wrist collapses into a predictable arthritis pattern (SNAC wrist). Early diagnosis with CT or MRI and appropriate treatment prevents this entirely.

Q 7 How long does recovery take after wrist fracture surgery?

After volar locking plate fixation, the wound heals in 2 weeks, the splint is typically removed at 2–4 weeks, and physiotherapy begins immediately. Most patients regain functional motion and grip strength by 3–4 months. After scaphoid fixation, the bone takes 8–12 weeks to unite, with full activity returning at 3–4 months for uncomplicated cases.

Wrist Injury or Chronic Wrist Pain in Peshawar?

A missed scaphoid fracture treated today avoids a wrist reconstruction in five years. A malunited radius fracture corrected early avoids irreversible arthritis. The correct assessment at the right time changes the outcome permanently.

Peshawar Clinic: Mon–Fri 4:00 PM – 7:30 PM · Sunday 12:00 PM – 4:00 PM | Charsadda: Saturday 9:00 AM – 7:00 PM