Wrist Fracture
A broken bone in the wrist, often from a fall
Quick Facts
- Type: Bone fracture of the wrist
- Most common bone: Distal radius (forearm)
- Usual cause: Fall onto an outstretched hand
- Treatment: Casting or surgery, then therapy
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 ulna) and eight small carpal bones. By far the most common wrist fracture is a break of the distal radius, the end of the larger forearm bone nearest the hand. Another important type is a fracture of the scaphoid, one of the small carpal bones, which is easy to miss and slow to heal.
Most wrist fractures happen when a person falls and instinctively puts out a hand to break the fall, driving force up through the wrist. They are common in older adults with weaker bones and in younger people during sports and high-energy accidents. Treatment ranges from a simple cast for stable breaks to surgery for displaced or unstable fractures. With proper care, most wrist fractures heal well, though some stiffness or aching can persist during recovery.
Symptoms
A wrist fracture usually causes immediate pain and difficulty using the hand and wrist.
- Sudden pain and tenderness in the wrist, often worse with movement
- Swelling and bruising around the wrist
- A visibly bent, crooked, or deformed wrist in more serious breaks
- Difficulty or inability to move the wrist or grip
- Numbness or tingling in the fingers if a nerve is irritated
A scaphoid fracture can be deceptive: it may cause only mild pain and tenderness in the hollow at the base of the thumb (the "anatomical snuffbox") and is sometimes mistaken for a sprain, yet it needs proper treatment to heal.
Causes
Wrist fractures are caused by force transmitted through the wrist bones, most often from a fall:
- Falls onto an outstretched hand: The most common mechanism, in slips, trips, and sports.
- Sports injuries: Skiing, snowboarding, cycling, skating, and contact sports.
- Motor vehicle and high-energy accidents: Can cause severe, displaced fractures.
- Weak bones: Osteoporosis makes fractures more likely from even minor falls, particularly in older adults.
- Direct blows: A hard impact directly to the wrist.
Risk Factors
- Osteoporosis or low bone density
- Older age, especially in postmenopausal women
- Participation in contact, wheeled, or winter sports
- Falls, poor balance, or vision problems
- Previous fracture
- Conditions or medications that weaken bone
Diagnosis
A clinician diagnoses a wrist fracture through examination and imaging.
- Physical examination: Checking for tenderness, swelling, deformity, and wrist and finger movement, and testing sensation and circulation in the hand.
- X-rays: The main test to confirm a break and show its position.
- Repeat X-rays or MRI: A scaphoid fracture may not show on early X-rays, so a wrist may be splinted and re-imaged in one to two weeks, or an MRI or CT scan obtained.
- CT scan: Used for complex fractures to plan treatment.
Treatment
Treatment depends on which bone is broken, whether the pieces are out of place, and how stable the fracture is.
- Realignment (reduction): A displaced fracture may be gently moved back into position, sometimes with local anesthesia, before being immobilized.
- Casting or splinting: Stable fractures are held in a cast or splint for several weeks while the bone heals.
- Surgery: Unstable or badly displaced fractures may need surgery with pins, plates, or screws to hold the bones in place.
- Pain relief and elevation: Keeping the wrist raised and using recommended pain medicine reduces swelling and discomfort.
- Hand therapy: After the bone heals, exercises restore motion, strength, and grip.
Most wrist fractures heal over about six to eight weeks, though scaphoid fractures and surgically treated breaks may take longer, and regaining full strength can take several months.
Prevention
- Keep bones strong with adequate calcium, vitamin D, and weight-bearing exercise
- Get screened and treated for osteoporosis if at risk
- Reduce fall hazards at home and improve lighting and footing
- Wear wrist guards for skating, skiing, and similar activities
- Address balance and vision problems that increase fall risk
When to See a Doctor
Seek prompt medical care after a wrist injury if you have significant pain, swelling, or trouble moving the wrist, or if it looks bent or deformed. Go to emergency care if the wrist is clearly out of shape, the skin is broken over the injury (an open fracture), or the hand becomes pale, cold, or numb, which can signal pressure on nerves or blood vessels. Even a wrist that seems only sprained should be checked if tenderness at the base of the thumb persists, since a scaphoid fracture can be missed.
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. Signs that point to a fracture include severe pain, a deformed or crooked wrist, and inability to move it. Because some fractures, especially of the scaphoid, mimic sprains, a wrist injury with persistent tenderness should be x-rayed.
How long does a wrist fracture take to heal?
Most distal radius fractures heal in about six to eight weeks in a cast, though regaining full strength and motion can take several months. Scaphoid fractures often heal more slowly, and surgically treated fractures may also need extra recovery time.
Will I need surgery for a broken wrist?
Not always. Stable fractures that are in good position are usually treated with a cast or splint. Surgery with pins, plates, or screws is used when the bones are displaced, unstable, or cannot be held in alignment, or for certain complex fractures.
Why are scaphoid fractures considered serious?
The scaphoid has a limited blood supply, so it heals slowly and is at risk of not healing properly if missed or untreated. Because it can cause only mild pain that resembles a sprain, doctors often splint and re-image a suspected scaphoid injury to avoid missing it.
When is a wrist fracture an emergency?
Seek emergency care if the wrist is clearly deformed, the bone breaks the skin, or the hand becomes pale, cold, numb, or severely swollen. These signs may indicate an open fracture or pressure on nerves and blood vessels that needs urgent treatment.
References
- American Academy of Orthopaedic Surgeons (AAOS). Distal Radius Fractures (Broken Wrist).
- Mayo Clinic. Broken wrist — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Wrist injuries and disorders.
- OrthoInfo, American Academy of Orthopaedic Surgeons.