Wrist Fractures

Overview

A wrist fracture is the medical term used for a broken wrist. The wrist is made up of eight bones that connect with the forearm bones, known as the radius and the ulna. A fractured wrist can result when any of these bones are injured. The most common type of wrist fracture is the result of a break in the radius bone, known as a Colles’ fracture or radius fracture.

Anatomy

The eight small bones of the wrist are connected by ligaments, nerves and tendons, which allow for rotation, flexibility and movement in different directions. These bones, also known as carpal bones, are placed in two rows:

The first row, known as the proximal row and located closest to the forearm, is composed of the:

• Scaphoid
• Lunate
• Triquetrum
• Pisiform

The second row, known as the distal row and located closest to the fingers, is composed of the:

• Trapezium
• Trapezoid
• Capitate
• Hamate

DESCRIPTION

A wrist fracture can occur for many reasons. Most commonly, it is the result of an injury when falling onto a hand that is outstretched. Other causes include severe trauma to the wrist and forearm from a motor or vehicle accident, direct trauma from high-risk contact sports, and can even be the result of frail and weakened bones due to conditions such as osteoporosis.

SYMPTOMS

A wrist fracture can result in great pain, and the symptoms can depend on the severity of the injury. General symptoms may include:

• Tenderness
• Swelling
• Bruising
• Paleness in the fingers or wrist
• Tingling or numbness throughout the fingers, wrist, and arm
• Deformity of the fingers and wrist, causing it to look bent or crooked
• Stiffness and inability to move wrist or fingers

DIAGNOSIS

Your Florida Orthopaedic Institute physician will evaluate your symptoms and determine the cause of your pain. A fractured wrist can sometimes be determined through a physical exam. A series of X-rays may be performed since a fracture to the small bones may often be challenging to detect at first glance.

TREATMENT (OVERVIEW)

Your physician will discuss all options for your treatment to determine which is the best for your needs. Treatment required to heal a fractured wrist will depend on the severity of the injury. In the beginning stages of the injury, over the counter painkillers such as (NSAIDs) like ibuprofen and aspirin can be used as an anti-inflammatory but if severe pain persists, your physician can determine if a stronger painkiller will be prescribed and if a cast or surgery is required.

NON-SURGICAL TREATMENTS

Florida Orthopaedic Institute physicians provide patients with all non-surgical options before surgery is recommended. If the pain is not as severe, non-surgical treatment methods can be used to reduce the pain of the fractured wrist. Generally, if a splint is required, it will be used in the initial stages while swelling subsides, and then a cast will be put on. Elevating your wrist with a pillow may ease any swelling and pain. A cast may need to remain on from six to eight weeks, or longer based on the injury. Regular checkups with X-ray will be essential to check the progress and determine if the cast is loosening. If the cast becomes too loose after additional swelling goes down, a new cast will be required to ensure that proper healing takes place.

SURGICAL PROCEDURES/TREATMENTS

Often, non-surgical treatments will be enough to fix a fractured wrist, but it is not uncommon to need surgery if a wrist is broken. Your physician may suggest surgery if the bone is not likely to heal correctly with a splint and cast. During wrist surgery, small pins, screws, plates or other devices are used to keep the bone in place to heal and mend.

NEXT STEPS

Whether surgery is required or not, upon receiving treatment it is important to allow your wrist to fully heal before returning to regular activity, to avoid reinjuring the fracture. Some patients may not reach full recovery right away and can continue to experience discomfort and pain for months or even years post-treatment. Physical therapy may be required to help to reduce symptoms and to bring back full mobility of your wrist. Follow your doctor’s care instructions and if severe pain persists, follow up to determine if extra treatment is required.

Florida Orthopaedic Institute’s Hand & Wrist center features the Bay Area’s greatest number of years of combined experience in hand and microvascular surgery. Our fellowship-trained microvascular surgeons provide the capability for complex reconstruction, as well as free tissue transfer and limb replantation.