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Wrist Fracture

Wrist Fracture

A wrist fracture is one of the most common orthopedic injuries and refers to a break in one or more of the bones that make up the wrist joint. The wrist is a complex structure consisting of eight small carpal bones, as well as the distal ends of the radius and ulna (the two long forearm bones). Among these, fractures of the distal radius are the most frequent type of wrist fracture, especially after falls or accidents.

This injury can occur in people of all ages but is particularly common in two groups: younger individuals who sustain high-energy trauma such as sports injuries or road accidents, and older adults, especially women with osteoporosis, who may suffer fractures from low-energy falls.

Anatomy of the Wrist

The wrist joint is formed by:

  • Distal Radius and Ulna – the two large forearm bones.
  • Carpal Bones – eight small bones (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate).
  • Ligaments and Tendons – which stabilize the joint and allow a wide range of motion.

Because of this complex structure, wrist fractures can vary greatly in type and severity, depending on which bones are broken and how the injury occurred.

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Causes of Wrist Fracture

The most common causes include:

  • Falls – Falling onto an outstretched hand is the leading cause.
  • Sports Injuries – High-impact sports like football, basketball, gymnastics, or skiing often lead to wrist fractures.
  • Motor Vehicle Accidents – Sudden trauma can result in multiple fractures.
  • Osteoporosis – Weakening of bones with age makes even minor falls a risk factor.

Types of Wrist Fractures

Wrist fractures can be classified into several types:

  • Distal Radius Fracture: The most common type, often called a “Colles’ fracture” when the broken fragment of the radius tilts upward.
  • Smith’s Fracture: The opposite of Colles’, where the broken fragment tilts downward.
  • Scaphoid Fracture: Involves one of the small carpal bones, common after falls.
  • Comminuted Fracture: Bone breaks into several pieces, often due to severe trauma.
  • Open (Compound) Fracture: The bone breaks through the skin, increasing the risk of infection.
  • Intra-articular Fracture: Break extends into the wrist joint, which may affect long-term mobility.

Symptoms of Wrist Fracture

Typical signs and symptoms include:

  • Immediate pain at the wrist.
  • Swelling and tenderness around the joint.
  • Bruising or discoloration.
  • Visible deformity, such as a bent or crooked wrist.
  • Inability to move or bear weight on the wrist.
  • Numbness or tingling in the fingers (indicating possible nerve involvement).

Diagnosis

Diagnosis usually involves:

  • Medical History and Physical Examination – The doctor checks for pain, deformity, swelling, and circulation to the fingers.
  • X-rays – The primary imaging test to confirm the fracture and its pattern.
  • CT Scan or MRI – Sometimes ordered to evaluate complex fractures or small carpal bone involvement.

Treatment of Wrist Fracture

The treatment depends on the severity, type of fracture, and the patient’s age and activity level.

Non-Surgical Treatment:

  • Immobilization – Minor or stable fractures are treated with a plaster cast or splint for 4–6 weeks.
  • Closed Reduction – If bones are displaced, they are realigned manually before casting.
  • Pain Management – Pain relievers and anti-inflammatory medications are prescribed.

Surgical Treatment:

When the fracture is unstable, displaced, or involves multiple fragments, surgery may be necessary. Options include:

  • Open Reduction and Internal Fixation (ORIF) – Plates, screws, or pins are used to stabilize the bone.
  • External Fixation – A frame is applied outside the body to hold the bones in position.
  • Bone Grafting – Sometimes used in severe cases to restore bone integrity.

Rehabilitation and Recovery

Recovery after a wrist fracture involves more than just bone healing. Proper rehabilitation ensures return of strength, flexibility, and function.

  • Immobilization Phase – The wrist is kept still until the bone heals sufficiently.
  • Physical Therapy – Once the cast is removed, exercises are started to improve movement and prevent stiffness.
  • Gradual Return to Activities – Light activities begin after healing, while heavy lifting or sports may take several months.

The healing process generally takes 6–12 weeks, but full recovery of strength and motion may take several months, depending on the severity of the fracture.

Complications

Although most wrist fractures heal well with proper treatment, complications can sometimes occur:

  • Stiffness and Reduced Mobility – Common if rehabilitation is delayed.
  • Arthritis – More likely after intra-articular fractures.
  • Malunion – Bones may heal in the wrong position, affecting function.
  • Nonunion – In some cases, the bone fails to heal.
  • Nerve or Tendon Damage – Rare but possible.

Conclusion

A wrist fracture is a common but potentially disabling injury if not treated properly. It can result from simple falls, sports, or severe accidents. Early diagnosis, proper treatment, and dedicated rehabilitation are crucial to ensure complete recovery and restore normal wrist function. With timely medical care and preventive measures, most people can return to their daily activities without long-term complications.

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