What are Wrist Fractures?
Wrist Fractures include injuries to the distal radius, ulna, the scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezium, and trapezoid–any of the bones which comprise the wrist joint.
A wrist fracture may occur when the person falls on an outstretched or flexed hand, as is common in biking, basketball, skateboarding, in-line skating, football, baseball, motocross, ATV, BMX, and rugby. Ladders, ice, wet floors and pot holes are other culprits.
Types of Wrist Fractures
A wrist fracture occurs when the supporting bones in your lower forearm or wrist joint break. Wrist fractures are categorized by which bones break and the architecture of the break and its mechanism. Fractures of the wrist are often very painful and are usually acute in nature.
Common types of wrist fractures include the following:
- Distal radius fracture: break of the distal end of the radius nearest to your hand.
- Colles fracture: the broken part of the radius tilts upward.
- Smith’s fracture: distal radius breaks while the wrist is in a flexed position.
- Barton’s fracture: fracture with a dislocation of the radiocarpal joint.
- Distal ulna fracture: fracture of the forearm bone on the pinkly side.
- Scaphoid fracture: a fracture that involves the scaphoid bone.
- Chauffeur’s fracture: a fracture involving the radial styloid bone.
- Greenstick fracture: one side of the bone is broken but the other side is only bent. Occurs only in children.
- Ulnar styloid fracture: that may occur in conjunction with a distal radius fracture at the very end of the pinky side forearm bone.
Characteristics and Clinical Presentation of Wrist Fractures
There are many ways athletes may sustain a wrist fracture. Falling onto an outstretched hand is always a risk factor. However, many patients may injure themselves while engaging in winter sports. Athletes who practice physical contact sports are also at a pronounced risk.
Some risk factors include:
- Acute physical trauma to the wrist.
- Falls or impact injuries during sports.
- Automobile accidents.
- Falling from a height
Wrist fractures manifest in chronic pain, weakness, and stiffness, oftentimes with the inability to operate the wrist. Symptoms of a wrist fracture may include:
- Stiffness, weakness
- Redness or bruising
- Decreased range of motion
Getting a Diagnosis for Wrist Fractures
An X-ray, CT or magnetic resonance imaging may be ordered for a more accurate diagnosis. An X-ray will confirm the diagnosis and provide information about how many broken pieces there are and whether the pieces have moved out of place.
Sometimes a CT scan is helpful to evaluate complex multi-fragment fractures. Most injuries are easily identifiable due to swelling, deformity to the region, bruising, or stiffness.
Treatment Options for Wrist Fractures
Before determining a treatment for a wrist fracture, your surgeon must assess whether or not the fracture is stable or unstable. For patients with a stable fracture, conservative treatments will promote healing in the wrist. Sensation and digital movements are evaluated for possible compromise to nerves and tendons.
Surgical intervention is nearly always required for patients with unstable or significantly misaligned fractures in order to optimize healing.
Conservative treatment methods are available for stable fractures. These methods include repositioning the bone, also called a closed reduction, and immobilizing the wrist with a splint or a cast.
Patients may also receive anti-inflammatory medication. Physical therapy is usually advised at some point.
In unstable wrist fractures, the injured bone(s) may shift out of place before proper healing. This may occur even if they are repositioned, resulting in a deformity called malunion, or even nonunion. Fractures may be stabilized with pins, plates, screws, rods, and external fixators.
In some cases, where a bone in the wrist has been severely crushed, a bone graft may be necessary to aid in the healing process.
Preventing a Wrist Fracture
Athletes may find that protective wrist splints may help prevent certain types of wrist injuries in specific sports.
However, most wrist fractures are the result of accidental falls or acute, physical contact. They can be somewhat difficult to prevent. Athletes should utilize proper, well-fitted safety gear in conjunction with proper body mechanics.
Prognosis for Wrist Fractures
In most cases, patients with this condition will undergo a period of immobilization and splinting. From there, treatment will be continued through hand therapy and rehabilitation with or without surgery.
Patients should begin physical therapy with their hand surgeon’s supervision to restore as much mobility and range of motion as possible in order to minimize joint stiffness.
If You Believe You Have a Wrist Fracture, Contact HandSport Surgery Institute.
Please contact us as soon as possible to schedule an appointment with our talented team. People who have been hurt should be evaluated to try to prevent further injury and mobility issues.
If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.