While fractures or breaks in the wrist can result from a number of different factors, most wrist fractures happen as a result of a fall. Someone slips and extends his or her arm to break the fall and ends up breaking their wrist instead. Breaks are more common in people with osteoporosis, a condition that makes the bones more brittle than normal and more likely to break.
No matter the cause, when a wrist is fractured or broken there is typically some pain and swelling. When the wrist or hand is moved, it may not work as well as expected and it can be stiff and difficult to use. The wrist, itself, may bend into an unnatural shape and look crooked.
Eight small bones, the radius and ulna make up our wrists. The way the bones are shaped and fitted together enables movement of our wrists in a variety of ways. Wrists typically move up and down, side to side, and can bend and rotate.
When a wrist is fractured, the most commonly broken bone is the radius. If one of the smaller bones, such as the scaphoid breaks, the wrist might not look any different, but there will still be pain.
Some fractures are considered "simple fractures". In such cases, the pieces of the fractured bone are still lined up. Other fractures are more serious and obvious because the wrist will be bent in an unnatural position. If the broken bones are unstable, or if the fragments have moved from their normal position, it is referred to as a comminuted fracture.
Evaluation & Diagnosis
Your hand surgeon will likely begin an evaluation with an examination of your wrist. X-rays are taken to determine if the wrist is fractured, especially if the injury is a simple fracture. After examining the wrist and studying the x-rays, the best treatment will be determined. If the x-ray is inconclusive or doesn't show injury to the bone or doesn't adequately show the state of bone fragments, a CT scan or MRI may be requested.
Injuries to the other tissues and structures in the wrist, to the ligaments that hold the bones together, to the muscles that move them, to the tendons that attach muscles to the bones, or to the nerves that tell the muscles to move or relay information about temperature or pressure can also result from trauma caused by the fracture. If any of the aforementioned structures were injured, they will need to be treated along with the fractured bone.
Treament of Wrist Fractures
The decision on how best to treat the fracture depends on a number of factors. First, the state of the bones is considered, and the treatment will vary depending on whether any bones need to be repositioned or the stability of the wrist.
One of our skilled hand surgeons will also take into account your age and overall health. Additional factors to consider are whether the wrist is connected to the hand used most often and what work and leisure activities your hands are used for. Any previous injuries to the wrist may also affect how the fracture is treated.
If the bones remained in place, or were moved back into position by your hand surgeon, either a splint or cast will be used to hold the wrist in place so as to facilitate healing. Before doing so, surgery may be needed to set the bone, and it may need to be held in place with pins, screws, rods, or plates, sometimes externally.
If the wrist is treated by external means, pins will be set above and below where the bone fractured, and these pins will be held in place by an external frame around the wrist. This will hold the bone in place until it heals.
Sometimes, as part of the injury that fractured the bone, part of the bone may be crushed or missing. In such cases, on of our hand doctors may need to perform a bone graft, using a bone from another part of your body to repair the problem. Synthetic bone can sometimes be used as well.
Unless there was an injury to the fingers, the fingers need to be moved continually to keep them from getting stiff while the fracture heals. When the wrist, itself, heals and once again becomes stable, you may be asked to do some exercises to keep it flexible.
Recovery & Healing
There is no specific amount of time it takes to recover from a wrist fracture. After all, a number of things can affect healing. While simple fractures can sometimes heal in as little as four to six weeks, more extensive injuries may take months before your wrist fully recovers. Even then, there may still be some pain.