If you or your child participate in sports or physical activities, it’s possible you have suffered a wrist fracture at one time or another. This involves breaking one or more of the bones in your wrist. This is a common injury; broken wrists make up one-tenth of all broken bones in the U.S.
It’s important to have these injuries addressed by the team at Orthopedic Associates of Long Island so that they heal properly.
WHAT IS A WRIST FRACTURE?
Although your wrist feels solid, it is actually made up of eight small bones along with the two long bones of your forearm. A wrist fracture is when you break or crack one or more of these bones. The most common small bone broken is called the scaphoid; the most common long bone is the radius.
HOW CAN YOU TELL IF YOU’VE BROKEN YOUR WRIST?
After sustaining a wrist injury, these are the telltale signs you may have a wrist fracture:
- Severe pain that worsens when gripping, squeezing, or moving your hand or wrist
- Obvious deformity
If you think you may have broken your wrist, it’s not something to leave to chance. A delay in diagnosis and proper splinting/care can lead to poor bone healing, decreased range of motion, and decreased grip strength in the future.
COMMON CAUSES OF WRIST FRACTURES
Most wrist fractures are the result of a fall, whether during normal activities or when playing a contact sport or activities such as snowboarding or skateboarding. Car accidents can also often result in broken wrists.
The most common wrist fracture is known as Colles’ fracture. Also known as a “distal radius fracture,” this is a break in the larger of the two bones in your forearm. The bone breaks on the lower end, close to where it connects to the bones of the hand on the thumb side of the wrist.
HOW ARE WRIST FRACTURES DIAGNOSED?
Wrist fractures are straightforward diagnoses for the team at Orthopedic Associates of Long Island. In most cases, all that is needed is a physical examination of the wrist and hand and an x-ray. If we feel more detail is needed, or to see something we cannot see on an x-ray, we may use a CT scan or an MRI for diagnosis.
WRIST FRACTURE TREATMENT
In cases of a “hairline” break in the bone, we won’t have to reposition the bones. But in many broken wrists, the broken ends of the bone aren’t properly aligned or there may be a gap. In these situations, we need to manipulate the pieces back into position. This is called a reduction and can be very painful, so the patient is given either local or general anesthesia prior to moving the bones.
- Immobilization — The majority of these cases require either a splint or cast on the wrist and lower hand. A splint is often used for a few days to a week while the swelling goes down. Then a cast is placed over the wrist and lower part of the hand. The cast can be used for anywhere from 4-8 weeks, depending on the age of the patient and the type of fracture. This will restrict the movement of the broken bone so it can heal. To reduce early swelling and pain with a cast, you should keep your hand elevated above your heart as much as possible.
WHO IS A CANDIDATE FOR SURGERY TO REPAIR A FRACTURED WRIST?
Certain wrist fractures can require surgery. These are situations that could necessitate surgery:
- An open fracture (the bone has broken through the skin)
- A fracture in which the bone pieces move before they heal
- Loose bone fragments that could enter a joint
- Damage to the surrounding ligaments, nerves, or blood vessels
- Fractures that extend into a joint
HOW IS SURGERY PERFORMED TO REPAIR A BROKEN WRIST?
An incision is usually made directly above the break. Often this is for the purpose of reduction, called an open reduction, to fix the alignment. In an open fracture, surgery should be performed urgently. The exposed soft tissue and bone must be thoroughly cleaned and antibiotics started to prevent possible infection.
In wrist fracture surgeries, fixation is usually necessary to hold the bone in the correct position while it heals. These are the typical options:
- Metal pins
- Plate and screws
- External fixator (a stabilizing frame outside the arm with pins down into the bone on both sides of the fracture)
- Combination of techniques
RECOVERY AFTER WRIST FRACTURE SURGERY
These surgeries are quite varied due to the different variations and degrees of the fractures, so there isn’t a “set” course of recovery. Generally, the patient will have moderate pain that lasts from a few days to a couple of weeks. In most cases a combination of ice, elevation of the wrist above the heart, and non-prescription pain medications are sufficient.
Casts must be kept dry, so the patient needs to shower with a plastic bag taped around the area. If the cast becomes wet, it is difficult to dry.
It’s important to regain full motion of your fingers as soon as possible after you get your cast.
Once the cast or splint is removed, it’s likely there will be some stiffness in the wrist. This will generally resolve in a month or two and should continue to improve, but it could take months. If necessary, you may need physical therapy to overcome this and to regain full range of motion.
WHEN CAN I RESUME EXERCISE OR SPORTS AFTER A WRIST FRACTURE?
Most patients will be able to resume exercise that doesn’t involve the arms within 1-2 months after the cast is removed. Return to sports, such as football, skiing, or skateboarding, can usually come from 3-6 months after the injury.