ConditionInjuries & poisoning
Wrist Fracture (Broken Wrist)
A wrist fracture is a break in one of the bones of the wrist, most often the end of the radius (distal radius fracture) and sometimes the small scaphoid bone at the base of the thumb. It usually happens from falling onto an outstretched hand. Signs include pain, swelling, bruising, deformity and difficulty moving the wrist or gripping. Many fractures heal in a cast in about 6 weeks; displaced or unstable breaks may need realignment or surgery. Scaphoid fractures can be missed on first X-rays, so persistent pain needs follow-up.
Also called: Broken wrist, distal radius fracture, Colles fracture, Smith fracture, scaphoid fracture
At a glance
- What it is
- A break in the radius, ulna or carpal bones at the wrist.
- Common cause
- Falling on an outstretched hand; sports; car crashes.
- Who gets it
- Children and teens in sports, and adults over 50 with weaker bones.
- Signs
- Pain, swelling, bruising, deformity, tenderness, trouble gripping.
- Treatment
- Splint or cast; reduction (realignment); surgery with plates or pins for unstable fractures.
- Healing
- About 6 to 8 weeks for bone; full strength in 3 to 6 months or more.
When to get help
Call 911 or go to the ER
- A bone poking through the skin or an open wound over the injury
- A cold, pale or blue hand, or numbness, tingling or weakness in the fingers
- A badly deformed wrist after a high-energy injury, or other serious injuries
See a doctor within a day or two
- Wrist pain, swelling and bruising after a fall that makes it hard to move the wrist or grip: go to urgent care or the ER the same day for an X-ray
- Pain in the hollow at the base of the thumb (anatomic snuffbox) after a fall, even if you can move the wrist
- Severe, increasing pain, swelling or tightness under a cast, or numb or discolored fingers
Book a routine appointment
- Wrist pain after a fall that is still present 1 to 2 weeks later, especially with a "normal" first X-ray
- A wrist fracture from a minor fall after age 50: ask about bone density testing
Usually safe to manage at home
- A mild twist with minimal swelling, full movement and no bony tenderness, improving within a day or two
First aid for a suspected broken wrist
- Remove rings, watches and bracelets before swelling starts.
- Support the wrist in the position you found it with a splint (a rolled magazine or board padded with cloth) and a sling.
- Apply ice wrapped in a cloth for 15 to 20 minutes to reduce swelling.
- Keep the hand raised above the heart.
- Do not try to straighten it.
- Get it X-rayed at urgent care or the ER.
Types of wrist fractures
| Type | Description |
|---|---|
| Colles fracture | End of the radius breaks and tilts toward the back of the hand; classic "dinner fork" deformity after a fall on the outstretched hand |
| Smith fracture | The broken end tilts toward the palm; usually from a fall on a flexed wrist |
| Intra-articular fracture | Break extends into the wrist joint; higher risk of arthritis |
| Barton fracture | Radius fracture with wrist joint dislocation |
| Ulnar styloid fracture | Small bony tip of the ulna; often with a radius fracture |
| Scaphoid fracture | Small bone at the base of the thumb; often in young adults; can be missed |
| Buckle (torus) fracture | Children; the bone bends and buckles without breaking through; heals quickly |
| Growth plate fracture | Children and teens; needs careful follow-up |
Symptoms
- immediate, severe wrist pain, worse with gripping or moving
- swelling and bruising
- visible deformity
- tenderness over the bone
- numbness or tingling in the fingers in some cases
Sprained vs broken wrist
Both can cause pain, swelling and bruising after a fall, and it can be impossible to tell without an X-ray. Point tenderness over a bone, deformity, severe swelling, and pain in the anatomic snuffbox suggest a fracture. A wrist sprain usually improves noticeably within a few days.
Risk factors
- osteoporosis: a wrist fracture after a fall from standing is often the first sign
- falls: poor balance, slippery surfaces, older age
- sports: skating, snowboarding, skiing, football, gymnastics, cycling
Diagnosis
- X-rays from several angles show the fracture and its position.
- CT scan for complex fractures extending into the joint, for surgical planning.
- MRI or repeat X-rays after 10 to 14 days for suspected scaphoid fracture with normal initial X-rays. Until then, the wrist is splinted as if broken.
Treatment
Non-surgical
- Splint, then cast: for stable, well-aligned fractures, usually for about 6 weeks. Buckle fractures in children often need only a removable splint for 3 to 4 weeks.
- Closed reduction: realigning displaced bones without surgery, using local anesthetic or sedation, then casting.
- Follow-up X-rays to make sure the bones stay in place.
Surgery
Surgery is recommended for unstable, significantly displaced or joint-involving fractures, and many scaphoid fractures:
- Plates and screws (open reduction and internal fixation), the most common method.
- Pins (K-wires) or an external fixator.
- Screw fixation for scaphoid fractures.
In older adults with lower activity demands, a cast may give acceptable results even for some displaced fractures; the AAOS guideline supports individualized decisions.
Recovery
- keep the hand raised and move the fingers often to reduce swelling and stiffness
- keep the cast dry
- pain relief with acetaminophen (paracetamol) or NSAIDs as advised; follow the label dose
- hand therapy after the cast or surgery to restore motion and strength
Healing time
| Stage | Typical timing |
|---|---|
| Cast or splint | 4 to 6 weeks (longer for scaphoid, sometimes 8 to 12 weeks) |
| Light activities | 1 to 2 months |
| Most daily activities and work | 2 to 3 months |
| Full strength and sports | 3 to 6 months or more |
Complications
- stiffness and reduced grip strength
- malunion (healing in a poor position)
- carpal tunnel syndrome from swelling or bone position
- complex regional pain syndrome: severe pain, swelling and color change
- tendon rupture (especially the thumb tendon) after some fractures
- arthritis after joint fractures
- scaphoid nonunion or loss of blood supply, which can lead to arthritis
Prevention
- wrist guards for skating and snowboarding
- fall prevention: good lighting, removing trip hazards, balance exercises
- bone health: calcium, vitamin D, weight-bearing exercise, and osteoporosis assessment after age 50 or after a low-energy fracture
Frequently asked questions
How do I know if my wrist is broken or sprained?
It can be hard to tell. Deformity, severe swelling, pain over a specific bone, and pain at the base of the thumb suggest a fracture. Only an X-ray can confirm it, so get one if pain and swelling are significant after a fall.
How long does a broken wrist take to heal?
The bone usually heals in about 6 to 8 weeks, often in a cast. Regaining full motion and strength takes 3 to 6 months or longer. Scaphoid fractures can take longer to heal.
Do all broken wrists need surgery?
No. Many stable, well-aligned fractures heal well in a cast. Surgery is recommended for displaced, unstable or joint-involving fractures, and for many scaphoid fractures, especially in younger, active people.
Why does a scaphoid fracture need special attention?
The scaphoid has a fragile blood supply and can be missed on initial X-rays. If not treated properly, it may not heal or the bone can die, causing arthritis. Pain at the base of the thumb after a fall needs immobilization and follow-up imaging.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Orthopaedic Surgeons (OrthoInfo): Distal radius fractures (broken wrist)
- American Academy of Orthopaedic Surgeons: Clinical practice guideline on management of distal radius fractures
- American Society for Surgery of the Hand: Scaphoid fracture
- NHS: Broken arm or wrist
- Bone Health and Osteoporosis Foundation: Fractures and osteoporosis