A broken wrist is a common injury, and while the human body possesses a remarkable ability to heal, a wrist fracture requires professional medical intervention to ensure correct function is restored. A fracture is simply a break in one of the bones that make up the wrist joint, which includes the two forearm bones—the radius and the ulna—and the eight small carpal bones. The body will immediately begin the healing process by forming a blood clot and initiating bone cell production. However, for the wrist to regain its complex range of motion and strength, the fractured pieces must be held in precise alignment. Without external stabilization, the natural healing process will likely fail to achieve the anatomical position necessary for long-term health and usability.
Defining a Wrist Fracture and the Necessity of Treatment
The wrist is an intricate structure composed of ten bones that work together to allow for a wide variety of movements. The most frequent break, accounting for up to 25 to 50% of all fractures, occurs in the distal radius, the larger of the two forearm bones near the wrist joint. This part of the radius is particularly susceptible to breaking, often from a fall onto an outstretched hand.
A wrist fracture is categorized based on displacement and whether the break extends into the joint surface. A non-displaced or stable fracture means the bone pieces remain in acceptable alignment, often allowing for non-surgical treatment. Conversely, a displaced or unstable fracture means the fragments have shifted, making it impossible for the body to reconnect them in a position that permits normal wrist mechanics.
The central issue is the body’s inability to maintain the correct structural alignment while producing new bone cells. Any movement, even slight, can disrupt the delicate process of bone bridging across the fracture gap. Stabilization is required to preserve joint surfaces and bone length. The goal of treatment is anatomical reduction, the precise realignment of the bone pieces, to ensure functional healing.
Consequences of Untreated Fractures
Leaving a wrist fracture untreated significantly increases the risk of serious, permanent complications that can severely limit hand and wrist function.
Malunion
One of the most common negative outcomes is a malunion, which occurs when the bone heals in a deformed or incorrect position. This improper healing can lead to limited range of motion, chronic pain, and a visible deformity in the forearm. The altered biomechanics caused by a malunion can also accelerate the development of post-traumatic arthritis in the wrist joint years later.
Nonunion
Another serious complication is a nonunion, where the fracture fails to heal completely, leaving a gap between the bone fragments. This is particularly common with fractures of the scaphoid due to its fragile blood supply. Nonunion can cause persistent pain and weakness and, if left unaddressed, may lead to the eventual collapse of the scaphoid bone and severe degenerative arthritis.
Soft Tissue Damage
Untreated or severely displaced fractures also carry the risk of damaging surrounding soft tissues, including nerves and blood vessels. Nerve damage, such as to the median nerve, can result in numbness, tingling, and weakness in the hand. These long-term disabilities underscore why a fracture is not an injury that should be left to heal without professional guidance.
Standard Medical Interventions
The first step in treating a suspected broken wrist is diagnosis, which involves a physical examination and imaging, typically X-rays, to assess the fracture’s severity and stability. X-rays confirm which bone is broken, the degree of displacement, and whether the break extends into the joint surface. This information guides the decision between non-operative and operative management.
Non-Operative Treatment
If the fracture is non-displaced or can be realigned easily, non-operative treatment is used. This method involves a closed reduction, where a physician manually manipulates the bone fragments back into an acceptable anatomical position without making an incision. Following reduction, the wrist is immobilized in a cast or splint, usually for about six weeks. Serial X-rays are often taken during the first few weeks to ensure the fragments do not shift within the cast.
Operative Treatment
For unstable fractures, those that are severely displaced, or those extending into the joint, surgical intervention is the preferred approach. Open Reduction and Internal Fixation (ORIF) is a common surgical technique where an incision is made to directly visualize and reposition the bone fragments. The surgeon then uses internal fixation hardware, such as metal plates, screws, or pins, to hold the bone securely in place. This stable fixation allows for earlier movement of the wrist after surgery, which is beneficial for the long-term functional outcome. Other surgical options include external fixation or percutaneous pinning.
Post-Treatment Recovery and Rehabilitation
Once the bone has healed and the cast or fixation device is removed, the recovery phase shifts focus to regaining function. The wrist and forearm muscles often become stiff and weak after weeks of immobilization. Physical therapy is a necessary part of the post-treatment process, regardless of whether a fracture was treated with a cast or surgery.
Rehabilitation begins with exercises to restore the full range of motion in the wrist, targeting movements like flexion, extension, and rotation. This involves gentle, controlled movements, progressing from passive to active motion. As the wrist regains mobility, the focus shifts to strength training, using resistance bands and light weights to rebuild grip strength and muscle endurance.
The bone typically heals in six to eight weeks, but the overall recovery of full strength and mobility can take several months, often continuing to improve for up to a year. Completing the prescribed home exercise program is important for maximizing improvement and ensuring the wrist returns to its previous level of activity.