Wrist fracture - information and specialists

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

A wrist fracture is debilitating and unpleasant. A wrist fracture can occur after a traumatic event (fall) . If the affected person suffers from pain and there is swelling in the area of the hand, then a fracture is likely.

The following text explains which symptoms are typical, how the diagnosis is made and which treatment is used when. You can also find specialists for the treatment of a wrist fracture here.

ICD codes for this diseases: S62

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Article overview

Definition: What is a wrist fracture?

A wrist fracture is a break or rupture of the structures that form part of the wrist.

The wrist consists of:

  • The ends of the two long forearm bones radius and ulna and
  • Eight small bones that are located between the bones of the forearm and those of the hand

Doctors refer to these small bones as carpal bones. In addition to fractures of these structures, wrist fractures also include minor damage. This applies in particular to hairline fractures.

Anatomie der menschlichen HandAnatomy of the human hand @ Alila Medical Media /AdobeStock

Doctors also differentiate between:

  • Open fractures and
  • Closed fractures

Open fractures are characterized by the fact that the injured bone penetrates the skin.

In the case of a fracture to the joint of the hand, the radius is usually affected. A fracture of the radius (distal radius fracture) is the most common fracture in adults.

Fractures of the ulna or carpal bones occur much less frequently. Open fractures of the wrist are also rare.

Doctors also differentiate between

  • Colles and
  • Smith fractures

The distinction relates to the formation of the fracture and the displacement of the fracture end at the wrist.

If those affectedfall on their outstretched hand and bend it backwards, a Colles fracture occurs. The fracture end shifts towards the back of the hand.

In a Smith fracture, on the other hand, the wrist bends downwards when the hand is outstretched. The fracture end shifts towards the palm of the hand.

Behandlung Speichenbruch mit TitanplatteTreatment of radial fracture with titanium plate @ Henrie /AdobeStock

Symptoms: What are the symptoms of a wrist fracture?

A fracture of the wrist is hard to miss. There is usually severe pain and noticeable swelling in the affected area.

Restricted movement and tenderness are also frequently observed. In some cases, there is also a feeling of numbness in the tip of the index finger. This is due to damage to the median nerve caused by a fracture.

Causes and risk factors: How does a wrist fracture occur?

In most cases, a wrist fracture is the result of violence to the wrist. It mainly occurs as a sports injury or after accidents.

Falls also frequently lead to wrist fractures, as many people tend to catch the fall with an outstretched hand. This puts a lot of strain on the wrist.

In old age, even slight forces can lead to a fracture of the wrist, as the stability of the bones decreases. This is particularly the case for people with osteoporosis.

Sporting activities with high wrist strain and an increased risk of falling, old age and osteoporosis are risk factors.

Pure fatigue fractures, which are caused by overloading the joint without any particular force, are rare.

Examination and diagnosis of a wrist fracture

An X-ray examination is necessary to differentiate a fracture of the wrist from other injuries without any doubt. During this examination, doctors are able to take a close look at the wrist.

Fractures are clearly recognizable here. Without imaging procedures, however, closed fractures cannot be identified beyond doubt. This is also because sprains and contusions lead to similar symptoms and arise from similar situations.

In the case of certain fractures (scaphoid fractures) that affect the carpal bone, an X-ray is sometimes not sufficient to determine the fracture.

In this case, further imaging is necessary after a few days. Occasionally, other imaging procedures such as MRI or CT are also used if the diagnosis is unclear.

Therapy: Treatment for a wrist fracture

The treatment of a wrist fracture depends on the appearance of the fracture: The degree of bone displacement and the overall condition of the affected bones determine whether conservative treatment is possible.

This is usually the case. A cast immobilizes the wrist to allow the bones at the fracture site to grow together. In the case of a scaphoid fracture, however, doctors use a thumb spica splint to immobilize the wrist.

In some cases, it is necessary to align the displaced bones correctly beforehand and bring them into their previous position. This alignment is done either with or without surgical treatment.

In the case of closed reduction (alignment without surgery), doctors usually give the patient a strong painkiller. The administration of sedatives is also common.

Surgery is only necessary if repositioning is not possible without direct vision. This is the case with comminuted fractures or open fractures, for example.

Course and prognosis: How does healing progress?

In most cases, the fracture heals without complications. However, a feeling of instability can usually be observed after the cast or splint has been removed.

The instability is caused by the non-use of the affected structures and muscle atrophy. This disappears again over time.

Possible complications are

  • Persistent pain and
  • Permanent impairment of movement
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