Wrist Fracture

The wrist is comprised of two bones in the forearm, the radius and ulna, and eight tiny carpal bones in the palm. The bones meet to form multiple small and large joints. A wrist fracture refers to a break in one or more of these bones.

Types of wrist fracture include:

• Simple wrist fractures in which the fractured pieces of bone are well aligned and stable.
• Unstable fractures are those in which fragments of the broken bone are misaligned and displaced.
• Open (compound) wrist fractures are severe fractures in which the broken bones cut through the skin. This type of fracture is more prone to infection and requires immediate medical attention.

accident or workplace injuries. Certain sports such as football, snowboarding or soccer may also be a cause of wrist fractures. Wrist fractures are more common in people with osteoporosis, a condition marked by brittleness of the bones.

Signs and symptoms

The common symptoms of a wrist fracture include severe pain, swelling and limited movement of the hand and wrist. Other symptoms include:

• Deformed or crooked wrist
• Bruising
• Numbness
• Stiffness

Diagnosis

Your doctor performs a preliminary physical examination followed by imaging tests such as an X-ray of the wrist to diagnose a fracture and check the alignment of the bones. A CT scan may be ordered to gather more detail of the fracture, such as soft tissue, nerves or blood vessel injury, an MRI, to identify tiny fractures and ligament injuries, and/or bone scan, to identify stress fractures due to repeated trauma.

Treatment

Your doctor may prescribe analgesics and anti-inflammatory medications to relieve pain and inflammation.

Fractures that are not displaced are treated with either a splint or cast to hold the wrist in place.

If the wrist bones are displaced, your surgeon may perform fracture reduction to align the bones. This is performed under local anaesthesia. A splint or cast is then placed to support the wrist and allow healing.

Surgery

Surgery is recommended to treat severely displaced wrist fractures and is carried out under the effect of general anaesthesia.

External fixation, such as pins may be implanted to treat the fracture from the outside. These pins are fixed above and below the fracture site and held in place by an external frame outside the wrist.

Internal fixation may be recommended to maintain the bones in proper position while they heal. Devices such as rods, plates and screws may be implanted at the fracture site.

Crushed or missing bone may be treated by using bone grafts taken from another part of your body, bone bank or using a bone graft substitute.

During the healing period, you may be asked to perform some motion exercises to keep your wrist flexible. Your doctor may recommend hand rehabilitation therapy or physiotherapy to improve function, strength and reduce stiffness.

Risks and complications

As with any procedure, wrist fracture surgery may involve certain risks and complications such as:

• Infection
• Residual joint stiffness
• Arthritis