Wrist Fractures
What is a wrist fracture?
The wrist is made up of eight small bones and the two forearm bones, the radius and ulna. A fracture may occur in any of these bones when enough force is applied.
The shape of the wrist bones allows the wrist to bend and straighten, move side-to-side, and rotate, as in twisting the palm up or down. A wrist fracture can happen after a fall onto an outstretched hand. More severe injuries may happen from a stronger force, such as a car accident or a fall from a roof or ladder. Osteoporosis, a condition in which bone becomes more brittle, may make a person more likely to get a wrist fracture.
The most commonly broken bone of the wrist is the radius. Many people think a fracture is different from a break, but they are the same. When the wrist is broken, there may be pain, swelling, and decreased use of the hand and wrist. Often the wrist appears crooked or deformed. Fractures of small wrist bones, such as the scaphoid, are less likely to appear deformed.
Fractures may be simple, with bone pieces aligned and stable. Other fractures are unstable, meaning the bone fragments may shift. Some fractures involve the normally smooth joint surface, while others are near the joint but leave the joint surface intact. Sometimes the bone is shattered into many pieces, which usually makes it unstable. An open, or compound, fracture occurs when a bone fragment breaks through the skin and has some risk of infection.
How are they evaluated?
Examination and x-rays are needed so your doctor can tell whether there is a fracture and help determine treatment. Sometimes a CT scan or MRI may be used to get better detail of the fracture fragments and associated injuries.
In addition to the bone, ligaments, tendons, muscles, and nerves may also be injured when the wrist is broken. These injuries may need to be treated along with the fracture.
How are they treated?
Treatment depends on the fracture pattern, whether the fracture is displaced or non-displaced, and whether it is stable or unstable. Other important considerations include age, overall health, hand dominance, work and leisure activities, prior injury or arthritis, and associated injuries.
A splint or cast may be used to treat a fracture that is not displaced, or to protect a fracture that has been set. Other fractures may need surgery to properly set and/or stabilize the bone.
Fractures may be stabilized with pins, screws, plates, rods, or external fixation. External fixation uses a frame outside the body attached to pins placed in the bone above and below the fracture site. Sometimes arthroscopy is used in the evaluation and treatment of wrist fractures. Your hand surgeon will determine which treatment is most appropriate for your individual case.
Occasionally, bone may be missing or so severely crushed that a gap remains after it has been re-aligned. In these cases, a bone graft may be necessary. Bone may be taken from another part of the body, from a bone bank, or a synthetic bone graft substitute may be used.
While the wrist fracture is healing, it is very important to keep the fingers flexible, as long as there are no other injuries that require finger immobilization. Once the wrist has enough stability, wrist motion exercises may be started. Hand therapy is often used to help recover flexibility, strength, and function.
What kind of results can I expect?
Recovery time varies considerably depending on the severity of the injury, associated injuries, and other factors. It is not unusual for maximum recovery from a wrist fracture to take several months. Some patients may have residual stiffness or aching. If the joint surface was badly injured, arthritis may develop. On occasion, additional treatment or reconstructive surgery may be needed.
This mobile-friendly version is adapted from patient education content originally provided by the American Society for Surgery of the Hand.