Wrist Fractures
What is a fracture of the wrist?
The wrist is a complex structure that is made up of the two bones of the forearm, the radius and ulna, and the eight small carpal bones located at the base of the hand. A break in any of those bones can be categorized as a wrist fracture, although most such fractures involve the radius or the scaphoid, the carpal bone at the base of the thumb.
Fractures of the wrist make up approximately 25 percent of limb fractures. They are common among children and adolescents, especially those who engage in risky activities, and in the elderly, where the incidence of falls is high and the bones tend to be more brittle.
What are its common causes?
The vast majority of fractures of the wrist result from the attempt to break a fall with an outstretched arm, but a blow to the wrist can also be responsible. A chauffeur’s fracture, for example, is named for the type of damage done in the early days of automobiles, when a hand crank used to start the engine was liable to forcefully kick back if the engine backfired. Hand cranks may now be obsolete, but automobile accidents remain prominent among the causes of wrist injury.
What are common wrist fractures?
The distal radius, that part of the radius closest to the hand, is the most common fracture location. Depending on the precise nature of the break, a distal radius fracture may be classified as a Colles’ fracture, Smith’s fracture or, if the radiocarpal joint is dislocated, Barton’s fracture. Fractures of the ulna are relatively widespread, but not as common as radial fractures.
The scaphoid is the most commonly injured of the carpal bones, as its location exposes it to more potential trauma, but none of those bones are immune.
What are the symptoms of the injury?
Fractures present with wrist pain, tenderness and swelling. If bones have been displaced or joints dislocated, the wrist may appear deformed. Movement of the wrist or attempting to grasp objects with the fingers may also be very painful.
Treatment Options
Non-Surgical Treatment Options
A fractured wrist is generally treated non-surgically by providing analgesic medication, reducing any swelling and applying a cast. If bones are out of position, a closed reduction, in which the bones are moved back into their proper positions, may be necessary before the cast is applied.
Surgical Treatment Options
Some fractures, especially displaced fractures, may need surgery because the bones cannot be properly positioned with a closed reduction or because even a properly applied cast may not maintain that position. Surgery may also be necessary where cartilage has been damaged, since cartilage, unlike bone, does not restore itself.
Surgery is generally performed under regional or general anesthesia after thorough evaluation of the wrist through X-ray, MRI or CT scan. Use of an arthroscope may be indicated to provide an additional view. Bone fragments can be attached with pins or with screws and plates in a procedure known as open reduction internal fixation. The surgeon may also choose external fixation, a procedure in which pins are inserted into the bone and held in place by clamps outside the body.
Recovery Time
Recovery time depends on the extent of the injury, the means of treatment and the success of that treatment. When surgery is not required, a cast may need to be in place for up to 12 weeks. If surgery is indicated from the start, or if non-surgical treatment has been inadequate to properly secure the bones, recovery is likely to take several months.
Wrist Fractures Animation Videos
Distal Radius Fracture (Broken Wrist)
Scaphoid Fractures
Colles Fractures
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