A broken wrist, or wrist fracture, typically causes immediate swelling, pain, and tenderness.
The wrist consists of eight small bones that connect to two long bones in the forearm: the ulna and the radius. The radius is on the same side as the thumb, and the ulna is on the same side as the small finger.
Although any of these bones can break or fracture, the American Academy of Orthopaedic Surgeons (AAOS) notes that the most common bone to break is the radius. Doctors call this a distal radius fracture.
A distal radius fracture nearly always happens approximately 1 inch from the end of the bone.
This article reviews the signs and symptoms of a broken wrist, when to consult a doctor, diagnosis, and more.
If a person breaks their wrist, they experience immediate pain, bruising, tenderness, and swelling. The wrist may also hang or appear unusually bent.
People may not be able to move the hand or fingers, although this is not always the case.
Is it fractured or sprained?
It may be difficult to tell the difference between a sprain and a fracture.
The AAOS states it is possible to mistake a wrist fracture for a mild or moderate wrist sprain.
Symptoms of a sprained wrist include:
A person should contact a doctor to determine if a break did occur.
If a person is not in much pain and the wrist does not appear to be at an unnatural angle, it may be possible to contact a doctor the next day. In the meantime, a person can use a splint, apply an ice pack to the wrist, and keep it elevated.
However, a person should go to the emergency room if:
- they are in a lot of pain
- the wrist is bending or hanging at an odd angle
- the fingers are pale or numb
Numbness in the fingers could be a sign of nerve damage. A doctor will need to address this quickly to prevent permanent nerve damage.
To diagnose a broken wrist, a doctor will likely need to order an X-ray to confirm a break and help determine its severity.
Sometimes, they may order additional imaging, such as a CT scan, to help plan surgery.
What to expect at the appointment
A doctor will review a person’s reasons for coming in and check their vital signs. They will also perform a physical examination of the wrist.
They may ask a person to rate their pain and provide details on the cause of the injury. If they suspect a break, they will likely order an X-ray to confirm and better analyze the break.
Questions to ask a doctor
A person may want to attend the appointment prepared with questions. Some questions a person may consider asking include:
- How long will recovery take?
- When can I return to my usual activities?
- What treatments do you recommend?
- What pain relievers will work based on my medical conditions or current medications?
- Will I need a cast or other bracing?
There are several potential treatment options for a person based on their overall activity level, age, and severity of the break.
Treatment needs to put the two pieces of bone back together and kept in place until healing has occurred. Several therapies can help with this.
Nonsurgical
Nonsurgical refers to any treatment that does not need a surgical procedure.
In nonsurgical cases, a doctor may apply a cast directly to a clean break or adjust the position of the bones and then apply a splint or cast.
If the bones are aligned, a person may need to wear a splint for the first few days to allow for swelling. They will then need to wear a cast a few days or a week later. As the swelling reduces, a person will require a new cast to properly fit the wrist.
The AAOS states that after 3 weeks, the doctor will recommend a 6-week follow-up X-ray. If the bone has healed properly, they will remove the cast.
Following the removal of the cast, the person will likely need physical therapy. Physical therapy will help restore function to the wrist and arm.
To help manage pain and swelling, a doctor may recommend over-the-counter (OTC) or prescription medications.
Surgical
A person may need surgical intervention in the case of severe breaks.
During a surgical procedure, the surgeon makes an incision in the wrist and then moves the bones back into alignment. They will then choose one or more options to hold the bones together.
They include:
- plates and screws
- metal pins, which doctors often use in children with growing bones
- a rigid frame called an external fixator, placed on the wrist and arms to keep the bones stationary during recovery
Surgery is required within 24 hours if a person has experienced an open fracture. This is when the bone breaks through the skin.
Recovery time will vary based on several factors, including age, overall health, the severity of the break, and whether or not surgery was necessary.
During recovery, a person will need to move their fingers to maintain strength and prevent stiffness.
Most distal radial fractures heal enough for people to return to their usual activities in approximately 3 months. It can take up to 1 year to recover fully.
Following the break, a person can expect moderate pain for several days to several weeks. It should gradually start to feel better.
Pain management may involve OTC or prescription-strength medication.
Some doctors may recommend using ibuprofen and acetaminophen for a combined effect on the pain. They may also prescribe an opioid for a short time.
Ice and keeping the wrist elevated can also help a person relieve their pain.
A person should follow all instructions that the doctor or nursing staff provides regarding cast and wound care.
While wearing a cast, people should take care by:
- keeping the cast dry
- avoiding getting dirt, sand, and powders inside the cast
- refraining from pulling out the padding of the cast
- avoiding inserting objects, such as sticks and hangers inside the cast
- refraining from applying deodorants or powers to any itchy skin
- avoiding trimming the rough edges around the cast
People should inspect the cast and the skin around the cast regularly. People should contact a doctor if:
- the skin becomes sore
- the cast cracks or develops soft spots
- itching persists
A person should plan to keep their surgical incision clean and dry for at least 5 days, though a doctor can provide more instructions on this.
Returning to work and usual activities is possible for most people following a broken wrist. However, some people may experience severe breaks that limit their mobility and ability to fully return.
The AAOS states that stiffness following the removal of a cast is common and will typically resolve within about 2 months. However, it can take a few years to fully go away. Physical therapy can help with this.
A person can often return to light activities, including exercising the lower body, within 1–2 months of cast removal or surgery. For more strenuous activities, a person may need to wait about 3–6 months.
A person should follow all instructions from the doctor or nursing staff. They should also make sure to ease into activities to avoid reinjury.
In approximately
It is possible for people can also reinjure the wrist, particularly if they continue the activity that caused it in the first place, such as contact sports.
Complications can include:
- rebreaking the wrist
- infection at the incision site after surgery
- permanent nerve damage
Wrist fractures typically occur due to injury, and the most common cause is falling onto an outstretched arm.
Other ways a person may break their wrist include
- falling over
- playing contact sports
- having a car accident
- falling from a ladder
Those with osteoporosis — a condition in which the bones become more fragile — can break bones more easily, even from minor falls.
A broken wrist causes immediate pain, swelling, tenderness, and bruising. People may also notice that the wrist hangs at an unnatural angle.
If a person is not in much pain and the wrist is not hanging or bending at an unnatural angle, they can contact a doctor the next day. They should wear a splint, keep the wrist elevated, and apply ice packs in the meantime.
However, if an individual’s pain is severe, the wrist is hanging or bending at an unnatural angle, or the fingers are pale or numb, they should go to the emergency room.
Treatment involves either the use of casting or surgery. Surgery is typically an option in severe cases where a simple casting will not work.