The wrist comprises eight small bones along with the two forearm bones—the radius and ulna. These bones form several joints, each with ends lined by smooth cartilage and connected by ligaments. This design allows the wrist to bend, straighten, move side-to-side, and rotate (as when twisting the palm up or down). Wrist fractures can occur when significant force is applied—such as during a fall onto an outstretched hand, a car accident, or a fall from a height. People with osteoporosis, a condition that weakens bones, are especially prone to fractures from even minor falls.

CAUSES

The radius is the most commonly fractured wrist bone. When a wrist fracture occurs, the affected area typically exhibits pain, swelling, and diminished hand and wrist use. Depending on the type of fracture, the wrist may appear crooked or deformed, particularly if the fracture is unstable or involves multiple displaced fragments. Some fractures may disrupt the smooth joint surface, while others leave it intact. In severe cases, the bone can shatter into many pieces, and open (compound) fractures—where a bone fragment breaks through the skin—pose a higher risk of infection. Improper healing and bone alignment can lead to lasting motion limitations, arthritis, and chronic pain.

SIGNS AND SYMPTOMS

A thorough examination and x-rays are essential for diagnosing wrist fractures and assessing bone alignment. Occasionally, a CT scan is needed for a more detailed view of the fracture fragments. In addition to bone injury, the surrounding ligaments, tendons, muscles, and nerves may also be damaged. When a bone fragment protrudes through the skin, immediate care is critical to reduce the risk of infection. Numbness in the fingers may indicate nerve injury, highlighting the need for prompt evaluation and treatment.

TREATMENT

Treatment depends on several factors, including patient characteristics (such as age, activity level, occupation, hand dominance, prior injuries, and the presence of arthritis) and local factors like bone quality and fracture specifics. Non-displaced fractures or those with well-aligned bone and joint structures may be managed with a splint or cast for several weeks to allow healing. More complex or unstable fractures might require surgical intervention using pins, screws, plates, rods, or external fixation devices. Surgery can help maintain alignment and may allow for earlier movement of the wrist. In cases where bone is missing or severely crushed, a bone graft may be necessary to fill gaps after realignment. Throughout the healing process, it is vital to keep the fingers and shoulder flexible and eventually start motion exercises for the wrist. Hand therapy is often employed to regain flexibility, strength, and function. Recovery time varies widely, and some patients may experience residual stiffness, pain, or even arthritis, potentially requiring additional treatments or reconstructive surgery.