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Wrist Fracture: Causes, Symptoms and Treatment

A wrist fracture is a break in one or more of the bones around the wrist joint, most often caused by a fall. It is one of the most common fractures and requires prompt medical attention.

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Things worth knowing about "Wrist Fracture"

A wrist fracture is a break in one or more of the bones around the wrist joint, most often caused by a fall. It is one of the most common fractures and requires prompt medical attention.

What Is a Wrist Fracture?

A wrist fracture refers to a break in one or more of the bones that make up the wrist joint. The most commonly fractured bone is the distal end of the radius (the larger of the two forearm bones), which is why this injury is frequently called a distal radius fracture. Less commonly, the ulna or one of the small carpal bones -- most notably the scaphoid bone -- may be broken. Wrist fractures are among the most frequent fractures seen in emergency departments and affect people of all ages.

Causes

The most common cause of a wrist fracture is a fall onto an outstretched hand, often referred to as a FOOSH injury (Fall on an Outstretched Hand). Other causes include:

Sports injuries (e.g., skiing, cycling, or inline skating)
Road traffic accidents
Direct impact or crush injuries to the wrist
Osteoporosis, which weakens bones and significantly increases fracture risk, particularly in older women

Symptoms

Common signs and symptoms of a wrist fracture include:

Severe pain around the wrist, worsening with movement or pressure
Swelling and bruising (hematoma) around the affected area
Visible deformity of the wrist (e.g., the classic dinner fork or bayonet deformity in a Colles fracture)
Limited range of motion and reduced grip strength
Numbness or tingling in the fingers, indicating possible nerve involvement

Diagnosis

A wrist fracture is diagnosed using the following methods:

Physical examination: Palpation of the wrist, assessment of tenderness, swelling, and range of motion
X-ray: The standard imaging tool for identifying bone fractures, typically taken in two planes
Computed tomography (CT scan): Used for complex fractures or pre-surgical planning
Magnetic resonance imaging (MRI): Particularly useful for detecting scaphoid fractures and associated soft tissue injuries

Treatment

Non-Surgical Treatment

Stable, non-displaced fractures are commonly managed without surgery:

Plaster cast or splint: Immobilization of the wrist for 4 to 6 weeks
Functional brace (orthosis): An alternative to casting for selected fracture types
Pain management: Use of analgesics such as ibuprofen or paracetamol to relieve discomfort

Surgical Treatment

Displaced or unstable fractures often require surgical intervention:

Plate and screw fixation (open reduction internal fixation): Realignment and stabilization of bone fragments using a metal plate
Kirschner wire (K-wire) fixation: A minimally invasive method using thin metal wires to hold bone fragments in place
External fixator: An external frame used to stabilize severely comminuted (shattered) fractures

Rehabilitation

Following immobilization or surgery, physiotherapy plays a vital role in restoring wrist mobility, strength, and function. Full recovery may take several weeks to months depending on the severity of the fracture and the treatment approach.

Complications

If not properly treated, wrist fractures can lead to the following complications:

Malunion -- the bone heals in an incorrect position, causing lasting functional impairment
Carpal tunnel syndrome due to compression of the median nerve
Complex Regional Pain Syndrome (CRPS), also known as Sudeck's atrophy
Post-traumatic osteoarthritis of the wrist joint
Delayed healing or non-union (pseudarthrosis), which is particularly common with scaphoid fractures

References

German Society for Trauma Surgery (DGU): S2e Clinical Guideline on Distal Radius Fractures (2015, updated 2022)
Lill H., Voigt C.: Distal Radius Fracture - Diagnosis and Treatment. In: Der Unfallchirurg, Springer Medizin (2019)
World Health Organization (WHO): Global Report on Falls Prevention in Older Age (2007)

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