Wrist Fractures

Introduction

Wrist fractures are a common type of orthopedic injury.  They occur most often as the result of a fall. When we fall, it is our natural instinct to stretch out our arms in an attempt to cushion ourselves, and this causes our full body weight to land on our wrists.

Wrist Anatomy

The wrist has many joints grouped into the Midcarpal Joint and the Radiocarpal Joint. These joints are composed of several bones in our hand and two bones in our forearm. The wrist joints function to position our hand and fingers for movement.

Two bones in our forearm and three bones in our hand form the Radiocarpal Joint. The primary motion of the Radiocarpal Joint is to lower the hand and wrist downward and move it towards the little finger side.

The Scaphoid and the Radius bones are two of the most common places for fractures. The Radius is the widest bone in our forearm, located on the thumb side of our forearm. The Scaphoid is a small bone in our hand. It is located on the thumb side of the wrist.

Wrist Fracture Causes

Wrist Fractures most often result from a fall on an outstretched hand. There are several types of wrist fractures that can result from a fall or other source of injury.  The type and location of the wrist fracture depends on the position of your wrist during the impact.

  • Scaphoid Fractures occur more commonly in men between the ages of 20 and 40 years old They are less common in children and older adults.  Falls are the most frequent culprit of Scaphoid fractures; however, they are also a common injury from sports and motor-vehicle crashes. During impact, the Scaphoid will fracture if the wrist is flexed  at a 90 degree angle or greater.
  • Radius Fractures, also referred to as Colles Fractures, are very common among older adults. Older women with Osteoporosis are at the highest risk.
  • Wrist fractures can also occur in children.  Children’s bones are soft and tend to buckle when they break a fall.  These types of fractures in children are called Torus Fractures.

Wrist Fracture Symptoms

Symptoms of a Scaphoid Fracture may be mild and vary from person to person. A Scaphoid Fracture may cause a small amount swelling but no obvious hand deformity. However, a Scaphoid Fracture can cause swelling, pain, or tenderness on the back of the wrist near the thumb. The pain may increase during gripping activities. Some individuals may feel tenderness when pressure is applied to the Anatomical Snuffbox.  The Anatomical Snuffbox is a small cup-like depression located on the back of the hand at the base of the thumb.

Colles Fractures can be very painful and include swelling just above your wrist.  ou may not be able to lift or hold lightweight objects, and the arm may appear deformed just above the wrist, because of the backward angle of the fractured bone.

Wrist Fracture Diagnosis

You should see a doctor as soon as possible if you think you have fractured your wrist. From here, your doctor will make a diagnosis by examining your wrist and ordering an X-rays to provide a good picture of your bones. In some cases, the doctor may order a CT Scan or MRI Scan to get a better view of the wrist structures.

Wrist Fracture Treatment

Wrist fracture treatments are very individualized and differ from person to person and the severity of the fracture. Also, the location and type of your fracture will determine what treatment is appropriate.  Some fractures can be treated without surgery.

Many Scaphoid Fractures are treatable with casting only. However, with modern methods, surgery is generally considered the treatment of choice. This is because casting is used to hold your bones in proper placement while they heal. The cast is usually worn from six weeks to six months. Most Colles Fractures can be treated with casting or splinting. For this, the cast or splint is typically worn for about four to six weeks.

Wrist Fracture Surgery

Surgery is recommended for fractures that do not heal properly. It’s also recommended when the bones have broken in such a way that they are unlikely to remain aligned when set with a cast. There are a few options for surgery, including procedures called an Open Reduction and Internal Fixation or an Open Reduction and External Fixation.

Open Reduction and Internal Fixation refers to techniques that use surgical hardware to stabilize a fracture beneath the skin. The surgeon will make an incision and place your bones in the proper position for healing, then secure the bones together with surgical hardware, such as pins, screws, or metal plates.

 

Wrist Fracture Recovery

Physical or occupational therapy will follow surgery or casting. The therapist will work with you to regain movement, strength, and function of your wrist. Like most injuries, recovery time from a wrist fracture is different for everyone.  It will depend on the type of fracture you had and the type of treatment you received.

In generally, wrist fractures take several weeks to heal.  Full recovery of motion and strength may take several months. Most people have good outcomes and regain good use of their wrists.

Wrist Fracture Prevention

There are several things that you can do to help prevent falls and decrease your risk of sustaining a wrist fracture. A physical examination can identify medical conditions that are associated with balance disorders or dizziness. An early diagnosis may allow for optimal treatment.

At SPORT, our orthopedic providers can help relieve the pain of a hand or wrist injury and restore your flexibility and range of motion. For an appointment at our Dallas or Frisco office, call (469) 200-2832 today or use our convenient online appointment request form.

Sports Physicians Orthopedics and Rehabilitation of Texas