Fracture of the Wrist
A break in one of the bones of the wrist
Quick Facts
- Type: Bone injury (fracture)
- Common cause: Fall onto an outstretched hand
- Most common bone: Distal radius
- Seek urgent care: Deformity, numbness, severe pain
Overview
A wrist fracture is a break in one of the bones that form the wrist. The wrist is made up of the lower ends of the two forearm bones, the radius and the ulna, plus eight small carpal bones. The most common wrist fracture is a break in the distal radius, the part of the radius closest to the hand. Another important wrist fracture involves the scaphoid, a small carpal bone.
Wrist fractures happen at all ages but are especially common in children, young people during sports, and older adults with weaker bones. Most are caused by falling onto an outstretched hand. With proper treatment, the great majority heal well, although some complex breaks need surgery.
Symptoms
Common symptoms of a broken wrist include:
- Immediate pain that worsens with movement or gripping
- Swelling and tenderness around the wrist
- Bruising
- A visible deformity, such as a bent or crooked wrist
- Difficulty or inability to move the wrist or hand normally
Numbness, tingling, or weakness in the fingers, a wrist that looks clearly out of shape, or skin broken over the injury are signs of a more serious fracture that needs urgent attention. A scaphoid fracture may cause only mild pain on the thumb side of the wrist and is easy to overlook.
Causes
Wrist fractures occur when more force is applied to the bone than it can withstand. Common causes include:
- Falls: Instinctively reaching out a hand to break a fall transmits force through the wrist.
- Sports injuries: Contact sports, skating, skiing, cycling, and similar activities.
- Motor vehicle accidents: High-energy crashes can cause complex breaks.
- Weak bones: Osteoporosis allows fractures to occur with relatively minor falls, especially in older adults.
Risk Factors
- Osteoporosis or low bone density
- Older age
- Participation in high-impact or contact sports
- Conditions that affect balance and increase falls
- Smoking and poor nutrition, which weaken bone
- Previous fractures
Diagnosis
A clinician examines the wrist for tenderness, swelling, deformity, and the range of motion, and checks circulation and nerve function in the hand. Imaging confirms the diagnosis:
- X-rays: The main test, showing most fractures and how the bone fragments are aligned.
- CT scan: Used for complex fractures or when surgery is planned.
- MRI: Helpful when a scaphoid fracture is suspected but not visible on early X-rays, since these breaks can be missed.
Treatment
Treatment depends on which bone is broken, how badly the fragments are displaced, and the person's age and activity level:
- Immobilization: A splint or cast holds the bone in place while it heals; this is enough for many stable, well-aligned fractures.
- Closed reduction: If the bone is out of position, a doctor may realign it without surgery before applying a cast.
- Surgery: Displaced, unstable, or open fractures may need surgery with pins, plates, or screws to hold the bone.
- Pain control and rehabilitation: Pain relievers, elevation, and later physical therapy to restore strength and movement.
Most wrist fractures heal over several weeks, though full recovery of strength and motion can take longer.
Prevention
- Keep bones strong with adequate calcium, vitamin D, and weight-bearing exercise
- Get screened and treated for osteoporosis if you are at risk
- Reduce fall hazards at home, such as loose rugs and poor lighting
- Wear wrist guards for activities like skating, snowboarding, and rollerblading
- Address vision and balance problems that contribute to falls
When to See a Doctor
Seek prompt medical care after a wrist injury if you have severe pain, swelling, or are unable to move or use the wrist. Go to emergency care right away if:
- The wrist looks deformed or bent
- Bone is visible or the skin is broken over the injury
- The hand or fingers are numb, tingling, pale, or cold
- Pain is severe and not improving
Even mild wrist pain on the thumb side after a fall should be checked, because a scaphoid fracture can be missed and may not heal well if untreated.
Frequently Asked Questions
How do I know if my wrist is broken or just sprained?
It can be hard to tell, because both cause pain and swelling. A broken wrist is more likely if there is a deformity, severe pain, or you cannot move the wrist. Only an X-ray can confirm a fracture, so an injured wrist that stays painful or swollen should be examined.
How long does a broken wrist take to heal?
Most wrist fractures heal in about six to eight weeks in a cast, but regaining full strength and motion can take several months. Scaphoid fractures and surgically treated breaks may take longer.
Do all wrist fractures need surgery?
No. Many stable, well-aligned fractures heal with a cast or splint alone. Surgery is reserved for displaced, unstable, or open fractures, or when the bone cannot be held in good position any other way.
Why are scaphoid fractures easy to miss?
The scaphoid bone may cause only mild pain on the thumb side of the wrist, and the fracture often does not show on early X-rays. Because an untreated scaphoid fracture can fail to heal, doctors may splint the wrist and repeat imaging or order an MRI.
Can a wrist fracture be a sign of weak bones?
Yes. In older adults, a wrist fracture from a minor fall can be an early warning sign of osteoporosis. Bone density testing and treatment may be recommended to prevent future fractures.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Distal radius fractures (broken wrist).
- Mayo Clinic. Broken wrist — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Wrist injuries and disorders.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Bone health.