Wrist Fractures

The wrist contains two forearm bones: the radius and the ulna. The most common fracture to the wrist occurs to the distal radius, the end of the larger of the two arm bones at the thumb-side of the wrist. Distal radius fractures usually happen about one inch from the end of the radius.  It is prone to injury when you fall on an outstretched hand or if there you have low bone density or osteoporosis. The injury causes pain, swelling, and bruising and can create a deformed appearance to the wrist.

The length of time for recovery varies greatly between patients. It is important to have your recovery guided by your physician and a certified hand therapist.  It is essential to keep the wrist elevated and to keep the fingers moving by making a tight fist as often as possible. There is no reason to use a squeeze ball.  An empty fist is the best. It is very common to have stiffness and swelling in the fingers and hand for quite some time after a wrist fracture.

TREATMENT OPTIONS 

Stable fractures that don’t affect the joint alignment are treated without surgery.  Initial treatment usually includes icing, elevating the arm, and anti-inflammatory medications to control pain and swelling. A splint may be used for 1 to 3 weeks to allow for swelling.  After the swelling has subsided, the splint will be replaced by a fiberglass cast. The wrist is typically immobilized for as many as 6 weeks after the injury. A sling may be worn for comfort, but it is important to work on maintaining full range of motion of the elbow and shoulder to prevent stiffness.

Fractures at the end of the bone, close to the thumb, usually heal in a few weeks when placed in a cast. For more serious fractures, your physician may suggest surgery in order to correct the alignment of the bone. Sometimes a cast alone can be used, or it may be necessary to insert metal pins, a plate, and screws. For more serious fractures, your physician may suggest surgery in order to correct the alignment of the bone. Sometimes a cast alone can be used, or it may be necessary to insert metal pins, a plate, and screws.

A fracture may also occur to the scaphoid bone, a small bone in the thumb-side of the wrist. A fracture of the scaphoid is a common sports injury and is usually a result of a fall toward an outstretched arm. When the scaphoid breaks at the waist or proximal pole, physicians may recommend surgery. Surgeons will use screws and wires to stabilize the bone so it can heal properly. After surgery, the wrist may be put into a cast. However, even with surgery these fractures can be difficult to heal.

If the scaphoid breaks in the middle of the bone or closer to the forearm, healing can be more difficult. It can also require a long-arm cast or surgery.

Regaining range of motion of the wrist and forearm is the focus for the first few months, followed by strengthening. In most cases, return to sports may be expected no sooner than 3 months from the beginning of treatment. After the cast is taken off, a removable splint can be worn. It can be worn either full-time or for strenuous activities until the fracture is fully healed.