Wrist Fractures

Overview

A wrist fracture is a broken bone in the wrist.

A fractured wrist is a common orthopedic injury. Wrist fractures make up approximately 25 percent of all limb fractures.

A distal radius fracture is the most common type of broken wrist. It is a break that occurs where the long radius bone in the forearm meets the wrist. In many cases, this type of wrist fracture occurs when a person falls on an outstretched hand.

Types of wrist fractures include:

• Colles Fracture — A Colles' fracture is a distal radius fracture where the broken bone fragment of the radius bone tilts up.
• Smith’s fracture — A Smith’s fracture can be caused by a forceful, direct blow to the forearm or by falling on flexed wrists.
• Scaphoid fracture — A scaphoid fracture is a break in the scaphoid bone (a bone on the thumb side) in the wrist. This type of wrist fracture is characterized by pain at the base of the thumb.
• Barton's fracture — A Barton's fracture is a type of fracture in the distal radius bone in conjunction with a dislocation in the radiocarpal joint. This type of fracture can occur on either the dorsal (backside) or palmar (palm side) of the wrist.
• Chauffeur’s fracture — A fracture in the forearm that can occur when the scaphoid bone is compressed against the styloid process in the distal radius.
• Greenstick fracture — A greenstick fracture occurs during infancy or childhood when a soft bone bends and breaks.
• Fracture of the ulnar styloid. A break in the ulnar styloid bone in the wrist. This type of fracture generally occurs at the same time as a distal radius fracture. 

Wrist fracture causes

The most common cause of a distal radius fracture is falling onto an outstretched arm.

Other causes of wrist fractures include:

• Car accidents
• Falls
• Trauma

Wrist fracture symptoms

Symptoms of a wrist fracture include:

• Pain.
• Tenderness.
• Bruising.
• Swelling.
• Deformed looking wrist.

Wrist fracture complications

Complications associated with a wrist fracture include:

• Chronic pain in the affected area of the wrist.
• Tendon rupture.
• Malunion of the joint during recovery.
• Instability in the wrist and hand.

Wrist fracture risk factors

Risk factors associated with wrist fractures include:

• Children, young adults, and the elderly are more likely to suffer a wrist fracture.
• Having osteoporosis. People with osteoporosis are more likely to suffer from wrist fractures because their bones are fragile.

Wrist fracture prevention

While all wrist fractures cannot be prevented, there are some ways to lower your risk of experiencing one.

• Wear wrist guards.
• Wear protective gear when participating in high-risk sports.
• Maintain good bone health by eating a balanced diet and strengthening bones.

Wrist fracture diagnosis

Your doctor can diagnose a wrist fracture with a physical examination and an X-ray. An X-ray will reveal if you have a broken bone, the location of the broken bone, and how many pieces the bone has broken into.

In some cases, your doctor may order other imaging tests such as:

• CT scan — A CT scan will reveal if you also have damage to the soft tissues and blood vessels.
• MRI scan — An MRI scan can identify microscopic fractures in the wrist.

Wrist fracture treatment

While some wrist fractures can be treated with a therapy called closed reduction, manipulating the bones back into the correct position, others may need surgical intervention.

Nonsurgical therapies

Patients who undergo closed reduction will need to schedule regular follow-up appointments with their doctor to confirm the bones are healing properly. During these appointments, at approximately every three weeks, your doctor will take an X-ray. The bones will also have to be immobilized in a splint or cast while the bones are healing. Keeping the arm above the heart and head as much as possible can reduce pain and swelling. After approximately six weeks, you can remove the cast, sling, or brace and begin physical therapy.

Medications

Your doctor will likely instruct you to take over the counter pain medications to keep pain at bay. If you have a fracture that pierces the skin, you may need an antibiotic.

Surgery

You may need surgery if your bone is so severely broken and cannot be manipulated back into place without surgery. During surgery for a broken wrist, your doctor will make an incision near the broken bone in a process called an open reduction. Your doctor will use a cast, metal pins, plates, or screws or an external frame to hold the bones in the correct position.

Your doctor will monitor your progress with X-rays as you recover to evaluate whether your bones are healing correctly. If your bones move, you may need surgery.

Your doctor may use an external fixation device that secures the bones in place by using a metal frame and pins that go into the skin on both sides of the fracture.

When to Seek Care

If you have a deformed wrist after a traumatic fall or injury, visit the emergency room right away. If the wrist is not extremely painful, you can schedule a clinic visit for the next day.

If you wait for a clinic visit, protect the affected area with a split, apply ice to the area, and elevate it until your appointment. 

Next Steps

Follow your doctor’s treatment and recovery plan carefully.

It is important to move your fingers to prevent them from getting stiff.

Hand therapy is essential to help you recover strength and motion in the hand.

Recovery from a risk fracture can take as long as a few months. Even after recovery, you may experience stiffness and dull aches. If you have a severe wrist fracture, you can develop arthritis in the joint.

If you start experiencing worsening symptoms or new symptoms, call your doctor for an appointment.