A wrist fracture is a break or crack in one or more of the bones that make up the wrist joint. The most common wrist fracture involves the radius bone of the forearm near the wrist. There are several types of wrist fractures, including:

Distal Radius Fracture: This is the most common type, occurring when the radius bone (the larger of the two forearm bones) breaks near the wrist end. It can be further classified into fractures that extend into the joint and those that do not. The position of the fracture, the bone quality, the number of pieces, and the chance that it worsens are all important in deciding treatment.

Scaphoid Fracture (see separate page): The second most common type, involving a break in the small scaphoid carpal bone near the base of the thumb. It often occurs from a fall onto an outstretched hand.

Radial Styloid Fracture: Also known as a chauffeur’s fracture, this involves a break in the pointed tip at the end of the radius bone near the thumb.

Ulnar Styloid Fracture: A break in the bony prominence at the end of the ulna bone (the smaller forearm bone) on the pinky side of the wrist. It often occurs along with a distal radius fracture.

Barton’s, Smith’s, and Colle’s Fracture are all descriptions of certain patterns or positions of the broken distal radius bone.

Other less common types include hairline fractures, buckle/torus fractures (incomplete breaks), fractures of other carpal bones like the triquetrum, trapezium, lunate, capitate, and hamate.

Common Symptoms

• Severe pain, worsening with gripping, squeezing or moving the wrist
• Swelling
• Tenderness
• Bruising
• Obvious deformity or bent wrist
• Numbness or tingling in the fingers

Cause & Anatomy

Common causes of Wrist Fractures:

• Falls onto an outstretched hand
• Sports injuries (contact sports, skating, snowboarding)
• Motor vehicle accidents
• Osteoporosis (weak bones) increases risk, especially in older adults

The wrist is made up of 8 small carpal bones and the ends of the radius and ulna bones of the forearm. The most commonly fractured is the distal radius (end of the radius bone near the thumb).

Diagnosis

Physical examination by a doctor feeling for tenderness, deformity and testing range of motion. X-rays are required to visualize and diagnose the fracture. Sometimes a CT scan or MRI may be needed.

Prevention

Build bone strength with a good healthy diet. Calcium, vitamin D, and other supplements or medications may be needed if you have deficiencies. Below are common ways to prevent Wrist Fractures:

• Weight-bearing exercise
• Wear protective gear for high-risk sports/activities
• Remove tripping hazards at home such as throw rugs
• Install grab bars and handrails
• Treat osteoporosis

Treatment

Depends on the type and severity of the fracture:

• Immobilization in a cast or splint
• Cast immobilization: A splint is initially applied for a few days, followed by a cast for 4-6 weeks to keep the bones in place while healing. The cast may need to be changed periodically.
• Monitoring: Regular X-rays are taken to ensure the bones remain properly aligned during healing. If displacement occurs, surgery may be required.
• Surgery to reposition and stabilize the bones (open reduction and internal fixation)
• Casting or splinting after surgery

Surgery

Open reduction and internal fixation (ORIF) is a common surgery where the bone fragments are repositioned into their normal alignment and held together with special screws and metal plates, or pins, attached to the bone.

Rehabilitation

After immobilization, physical/occupational therapy is often needed to:

• Regain strength
• Improve range of motion
• Manage stiffness and pain – Full recovery can take 6-12 months.

Initial Immobilization Phase

• Immobilization with a splint for 1-2 weeks for comfort, stability, and swelling control, and then a cast/fracture brace for 4-6 weeks to allow for early healing and long term stability.

After casting: gentle range of motion exercises for the fingers, elbow, and shoulder to prevent stiffness.

• Wearing a removable wrist splint or orthotic for around 4-6 weeks.
• Gradually increasing wrist and forearm range of motion exercises.
• Light functional use of the hand and arm with the splint on.

Motion and Strengthening Phase

• Discontinuing the splint around 6 – 8 weeks from injury or surgery (depending on the stability and type of the fracture).
• Focusing on regaining full wrist range of motion through stretching and mobilization exercises.
• Initiating strengthening exercises for the wrist, hand, and forearm muscles.
• Progressing to functional tasks and activities of daily living

FAQ’s

Which wrist bone is most commonly fractured?
The distal radius.

When does the pain stop after a wrist fracture?
Pain can persist for weeks to months.

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