The wrist is a complex joint composed of the radius, ulna, and eight small carpal bones. This intricate structure is frequently subjected to high forces, making fractures common, particularly from falls onto an outstretched hand. Distal radius fractures account for a significant portion of all fractures treated in emergency settings. Identifying a fracture quickly is important because an untreated break can lead to long-term pain, stiffness, and loss of function.
Recognizing the Key Symptoms
A suspected broken wrist often presents with immediate, severe, and sharp pain that intensifies with movement or attempted gripping. This pain is typically more intense than a sprain. Swelling and bruising are common signs, but a fracture usually causes more pronounced and rapidly developing swelling that may extend into the fingers.
A visible deformity or an abnormal bend in the wrist is a strong indicator of a fracture, often described as a “dinner fork” appearance. If you hear a distinct cracking sound or feel a grinding sensation (crepitus), it suggests bone fragments are rubbing together. Furthermore, a fracture carries a higher risk of nerve involvement, so symptoms like numbness or tingling in the hand or fingers warrant immediate medical attention.
Immediate First Aid Steps
If a wrist fracture is suspected, the first priority is to stop using the injured limb to prevent further displacement of bone fragments. Immediately immobilize the wrist in the position it was found, without attempting to straighten or manipulate the limb, as this could cause additional damage. A makeshift splint can be created using firm materials like rolled-up newspapers or sticks, secured above and below the fracture site to restrict movement.
Elevation is an effective measure to reduce swelling, so the wrist should be kept above the level of the heart whenever possible. Applying cold therapy helps mitigate pain and minimize soft tissue swelling. Ice should be wrapped in a cloth or towel before being placed on the affected area for 15 to 20 minutes, avoiding direct contact with the skin.
Professional Diagnosis and Assessment
Once at a medical facility, the initial step in confirming a fracture is a thorough physical examination, where the doctor assesses tenderness, swelling, range of motion, and any signs of nerve or blood vessel compromise. Standard X-rays are the most common and cost-effective method used to visualize the bone and determine the presence, location, and severity of the break.
If initial X-rays are inconclusive, or if the fracture involves the joint surface, more advanced imaging may be required. A Computed Tomography (CT) scan provides detailed, three-dimensional cross-sectional images useful for assessing complex fractures and the degree of joint involvement. MRI is reserved for situations where small bones like the scaphoid are suspected, or when associated soft tissue injuries need to be evaluated.
Common Treatment Approaches
Treatment for a confirmed wrist fracture depends on the type and stability of the break. Stable, non-displaced fractures, where bone fragments remain correctly aligned, are typically managed non-surgically with immobilization. This involves wearing a cast or splint for six to twelve weeks to allow the bone to heal naturally.
If the fracture is displaced, meaning the bone fragments are significantly out of alignment, reduction is necessary to reposition the pieces. If the fragments can be realigned without surgery, a closed reduction is performed, followed by casting. Complex, unstable, or highly displaced fractures, especially those involving the joint surface, often require Open Reduction Internal Fixation (ORIF) surgery. This procedure uses hardware like plates, screws, or pins to stabilize the bones internally, ensuring proper alignment for healing. Following immobilization or surgery, physical therapy is prescribed to restore the wrist’s full range of motion and strength.