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Wrist Fractures

What are wrist fractures?

A wrist fracture is a common injury that typically refers to a break in the radius, the larger of the two forearm bones, near the wrist joint. These fractures can occur in various ways but are commonly associated with a fall onto an outstretched hand. The severity of the fracture can vary, ranging from simple breaks to more complex fractures that involve the joint.

Wrist fractures are most often seen in two age groups:

  • Young adults, where high-energy trauma such as sports injuries or motor vehicle accidents is common.
  • Older adults, where lower-energy injuries, like falls, are the primary cause.

One of the most common types of wrist fractures is the Colles fracture, which occurs when the broken end of the radius tilts upwards.

  • Colles Fracture: The most common type, occurring when the radius breaks near the wrist and the fractured segment tilts upward.
  • Smith’s Fracture: This is the opposite of a Colles fracture, where the broken bone tilts downward.
  • Barton’s Fracture: Involves a fracture of the distal radius along with a dislocation of the wrist joint.
  • Scaphoid Fracture: A break in the small scaphoid bone, which is located on the thumb side of the wrist.

The most common cause of a wrist fracture is a fall onto an outstretched hand, but other causes include:

  • High-energy trauma from activities such as skiing, snowboarding, or cycling.
  • Low-energy trauma in older adults, often due to osteoporosis-related falls.

Direct impact from accidents, such as car collisions or sports injuries.

Common symptoms of a wrist fracture include:

  • Pain at the site of the injury, which may worsen with movement.
  • Swelling around the wrist and hand.
  • Deformity in severe fractures, where the wrist may look bent or out of place.
  • Bruising and tenderness.
  • Limited range of motion in the wrist or hand.

It is essential to seek immediate medical attention if you suspect a wrist fracture, especially if there is visible deformity or severe pain.

Wrist Anatomy

The wrist is a complex structure made up of multiple bones, joints, ligaments, and tendons that allow for a wide range of motion. The radius and ulna are the two forearm bones that connect to the eight small carpal bones in the wrist. These carpal bones are arranged in two rows and work together to enable movements such as flexion, extension, and rotation of the wrist. In wrist fractures, the most commonly affected bone is the radius, particularly in fractures like the Colles fracture or Smith’s fracture.

Treatment and Surgery Options

A wrist fracture is typically diagnosed through:

  • Physical examination: A doctor will assess the injured wrist for swelling, tenderness, and deformity.
  • X-rays: X-rays are the standard method for visualising bone breaks and fractures in the wrist.
  • CT scan: For more complex fractures, such as those involving the joint, a CT scan may be required to obtain detailed images of the break.

Many wrist fractures can be treated without surgery, particularly when the bones are in a stable position. Non-surgical options include:

  • Casting and Immobilisation: A cast or splint may be applied to keep the wrist stable while the fracture heals. This typically lasts for six weeks, and X-rays may be taken at different intervals to monitor healing progress.
  • Closed Reduction: For fractures where the bone is displaced, a doctor may manually manipulate the bone back into its proper position. Once realigned, a cast or splint is used to keep the wrist stable during recovery.
  • Physical Therapy: After the cast is removed, patients are often referred to a physiotherapist to restore range of motion and strength in the wrist.

In cases treated without surgery, a cast is typically worn for six weeks, with X-rays taken periodically to ensure proper healing. 

In some cases, surgery may be required to properly align and stabilise the broken bones. Surgical options include:

  • Plate and Screw Fixation: The most common surgical treatment for wrist fractures involves the use of plates and screws to hold the bones in place while they heal. The plate and screws are typically left in place and do not need to be removed unless they cause discomfort later on.
  • External Fixation: This method involves placing pins in the bone that extend out through the skin and are attached to an external frame. This stabilises the bones while they heal.
  • Percutaneous Pinning: In some cases, smaller pins are inserted through the skin to hold the bones in place while they heal.

Surgical options are typically chosen based on the severity of the fracture, the patient’s age, and the level of function required for daily activities.

Surgical recovery times may vary, with some patients wearing a removable brace for up to six weeks after the procedure. Physical therapy is an essential part of recovery, helping to restore range of motion, flexibility, and strength. Full recovery, including the return of strength and function, can take up to six months.

Downloadable info sheets related to Wrist Fractures

These notes from OrthoSport Victoria are for educational purposes only and are not to be used as medical advice. Please seek the advice of your specific surgeon or other health care provider with any questions regarding medical conditions and treatment.

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Phone: (03) 9038 5200
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89 Bridge Rd, Richmond, 3121