Broken wrist

In a broken wrist, one or more bones in the wrist region are broken. A fracture usually occurs from a fall on the outstretched hand. A broken wrist causes severe pain and sometimes a visible deformity of the forearm.

The wrist is a complex joint composed of two forearm bones and eight carpal bones. A broken wrist refers to a fracture of one or both forearm bones: the ulna (ulna) and/or the radius (radius). The end of the radius is most often involved in a fracture. A fracture of one or more of the carpal bones is also considered a wrist fracture. The severity of a broken wrist can range from a simple crack in the bone to displacement of the bone fragments.

How does a broken wrist occur?

Most often, a broken wrist results from a fall on the outstretched hand. This trauma (accident) is also known as a FOOSH injury, short for Fall On Outstretched Hand. In addition to a fall, a direct blow to the wrist or hand can cause a fracture. Combat sports or sports with a fall risk, such as skating or snowboarding, increase the risk of a broken wrist. The same applies to people with an underlying bone disease or osteoporosis (bone demineralization).

Symptoms with a broken wrist

Possible symptoms of a broken wrist are severe pain, swelling, bruising and a visible deformity of the wrist. The usually sharp pain worsens with movement of the wrist or hand.

Diagnosis of a broken wrist

The diagnosis of a broken wrist can in many cases be made after a history and physical examination by a (family) doctor. However, an X-ray will almost always be taken to determine the severity and location of the fracture.

If necessary, an additional CT scan or MRI scan may be performed. These studies can visualize the fracture in more detail and provide more information about associated soft-tissue damage to, for example, nerves or muscles.

Treatment of a broken wrist

Treatment depends on the location and severity of the fracture. With a crack in the bone, a nonoperative approach is almost always chosen. To protect the area and allow the bone to heal properly, a cast period of 4 to 6 weeks is often recommended.

For a fracture in which the bones are not aligned (unstable fracture), there are several treatment options. A reduction, in which the bone is 'set' back into position, possibly under local anesthesia, is preferred and is followed by casting.

The other option is surgery in which the surgeon fixes the bone with pins and plates. This procedure is mainly used for severe fractures or in people with poor bone quality.

In all cases, it is important to train the wrist again after the period of casting or enforced rest. Important treatment goals are restoring wrist mobility and the strength of the forearm and hand muscles.

The hand therapist is ideally suited to guide this process. Treatment methods used frequently include mobilization techniques, exercise therapy, medical taping and treatments to reduce pain.