Broken wrist

A broken wrist occurs when one or more bones of the wrist break or crack, often because of a fall. When falling, people instinctively reach out their hands to catch themselves. This can lead to a break or crack, also called a fracture.

Breaking a wrist is more likely if you play certain sports, such as snowboarding, skateboarding, in-line skating or pickleball. It also is more likely if you have osteoporosis, a condition that makes bones weaker and easier to break.

One common wrist fracture is called a scaphoid fracture. It happens when you break or crack one of the eight bones in your wrist, called the carpal bones. Another common wrist fracture is a distal radius fracture. This is a break or crack in the radius bone at the wrist. The radius bone is one of the long bones in the forearm.

It's important to treat a broken wrist right away. If not treated, the bones may not heal correctly. This makes everyday tasks, such as writing or buttoning a shirt, very hard. Early treatment also helps lessen pain and stiffness.

Common symptoms of a broken wrist include:

• Serious pain that may worsen when gripping or squeezing or moving your hand or wrist.
• Swelling.
• Tenderness.
• Bruising.
• Obvious physical changes, such as a bent wrist or crooked finger.
• Stiffness or inability to move your fingers or thumb.
• Numbness in your hand or fingers.

When to see a doctor

If you think you might have a broken wrist, see a doctor right away. If you have numbness, swelling or trouble moving your fingers, seek medical care right away. Delaying diagnosis and treatment can lead to poor healing, reduced range of motion and weaker grip strength.

A strong impact or crushing injury can break any of the bones in your wrists. Common causes include:

• Falls. Falling onto an outstretched hand is one of the most common causes of a broken wrist.
• Sports injuries. Fractures often occur during contact sports or activities where falling on an outstretched hand is likely. These include activities such as pickleball, snowboarding and in-line skating.
• Motor vehicle crashes. Car crashes can cause serious fractures, sometimes breaking bones into multiple pieces and requiring surgery to repair.

Participating in certain sports increases the risk of breaking a wrist. Having osteoporosis, a condition that weakens bones, also makes fractures more likely.

Sports activities

Contact sports and activities that increase the risk of falls can raise the risk of breaking bones in the wrist. These include:

• Football or soccer, especially on artificial turf.
• Rugby.
• Hockey.
• Pickleball.
• Skiing.
• Snowboarding.
• In-line skating.
• Jumping on a trampoline.
• Horseback riding.

Complications of a broken wrist are rare, but they include:

• Ongoing stiffness, aching or limited movement. While discomfort typically improves after a cast is removed or surgery is completed, some people have lasting pain or stiffness. Be patient with your recovery. Talk to your healthcare professional about exercises or a referral to physical or occupational therapy.
• Osteoarthritis. Fractures that extend into the joint can cause arthritis years later. If your wrist starts to hurt or swells long after a break, contact your healthcare professional.
• Nerve or blood vessel damage. A wrist injury can affect nearby nerves and blood vessels. If you have numbness, swelling or a change in the color of your skin, seek emergency medical care.

You can't always prevent unexpected events that lead to a broken wrist, but these tips may help reduce the risk.

Build bone strength

Build strong bones by:

• Eating a nutritious diet with enough calcium and vitamin D.
• Getting plenty of weight-bearing exercise, such as brisk walking.
• Quitting smoking if you smoke.

Prevent falls

Most broken wrists occur when people fall forward onto an outstretched hand. To prevent this common injury:

• Participate in a regular exercise program. Exercise makes you stronger. And exercises that improve balance and coordination are the most helpful.
• Wear sensible shoes.
• Remove things you can trip over in your home, such as throw rugs.
• Light up your living space.
• Have your vision checked and, if needed, corrected.
• Install grab bars in your bathroom.
• Install handrails on your stairways.
• Stay away from slippery surfaces, such as pool decks and snow- or ice-covered walkways.

Use protective gear for athletic activities

Wear wrist guards for high-risk activities, such as:

• Pickleball.
• Snowboarding.
• Skating.
• Rugby.
• Football.

Diagnosing a broken wrist typically involves a physical examination of the injured area and X-rays.

Other imaging tests

Sometimes, additional imaging tests can give more detail. These include:

• CT scan. CT scans can detect wrist fractures that X-rays may miss. A CT scan also helps identify injuries to soft tissues and blood vessels by combining multiple X-ray images to create detailed cross-sectional views of the injured area.
• MRI. Using radio waves and a strong magnet, an MRI produces highly detailed images of bones and soft tissues. It is much more sensitive than X-rays and can detect tiny fractures and ligament injuries.

If the broken bone ends aren't aligned, there may be gaps between the pieces of bone or overlapping fragments. To correct this, your healthcare professional does a procedure called a reduction. A reduction repositions the bone pieces so they have the best chance to heal well. Depending on your level of pain and swelling, you may need anesthesia before the procedure. Local anesthesia numbs a specific area of the body so you don't feel pain, but you remain alert and awake. General anesthesia puts you into a deep sleep. Often, a reduction may be done during surgery using general anesthesia.

Whatever your treatment, it's important to move your fingers regularly as you heal to prevent stiffness. Ask your healthcare professional about the best ways to move them. If you smoke, quit. Smoking can delay or prevent bone healing.

Immobilization

Limiting movement in a broken wrist is called immobilization. Whether your treatment is surgical or nonsurgical, you may need to wear a cast or splint for up to six months for proper healing. To reduce pain and swelling, you also will be advised to keep your hand elevated above heart level as much as possible.

Medicines

To manage pain, your healthcare professional may recommend a pain reliever you can buy without a prescription. For more serious pain, an opioid medicine may be prescribed.

NSAIDs can help with pain relief but may slow bone healing, especially with long-term use. Talk to your healthcare professional before taking NSAIDs.

If you have an open fracture, you'll likely be given an antibiotic to prevent infection from reaching the bone. An open fracture happens when the bone breaks through the skin or when there is a wound near the fracture.

Therapy

After your cast or splint is removed, you'll likely need rehabilitation exercises or physical therapy to improve flexibility and restore movement in your wrist. While rehab can help, full recovery may take several months or longer.

Surgical and other procedures

If immobilization isn't an option, you might need surgery to implant pins, plates, rods or screws to hold your bones in place while they heal. Or a bone graft may be used to help healing. These may be needed if you have any of the following:

• An open fracture.
• A fracture where the bone pieces move before they heal. This is called an unstable or displaced fracture.
• Loose bone fragments that could enter a joint.
• Damage to the surrounding ligaments, nerves or blood vessels.
• Fractures that extend into a joint.

Even after reduction and immobilization with a cast or splint, the bones can shift. Your healthcare professional typically monitors your progress with X-rays. If your bones move, you may then need surgery.

In some cases, a surgeon may stabilize the fracture using an external fixation device. This device includes a metal frame with two or more pins that go through the skin and into the bone on both sides of the fracture. This helps to hold the fracture in place during healing.

If you have a broken wrist, you may first seek treatment in an emergency room or urgent care clinic. If the broken bones aren't properly aligned for healing with immobilization, you may be referred to an orthopedic surgeon for further treatment.

What you can do

You may want to write a list that includes:

• A description of your symptoms and how, where and when the injury occurred.
• Information about your and your family's medical histories.
• All the medicines and dietary supplements you take, including doses.
• Questions you want to ask your healthcare professional.

For a broken wrist, questions to ask include:

• What tests do I need?
• What's the best course of action?
• Will I need surgery?
• Will I need to wear a cast? If so, for how long?
• Will I need physical therapy when the cast comes off?
• Are there restrictions that I need to follow?
• Should I see a specialist?

What to expect from your doctor

Your healthcare professional may ask:

• What is your occupation?
• Was your wrist or hand bent backward or forward when the injury occurred?
• Are you right-handed or left-handed?
• Where does it hurt: Do certain movements make it hurt more or less?
• Have you had previous hand or wrist injuries or surgery?