A broken wrist occurs when a bone breaks. Often caused by falls or sports, a cast immobilizes the area for healing, providing stability and protection. This reduces pain and swelling.
Factors Determining Cast Duration
Cast duration varies significantly based on individual and injury factors. Simple breaks heal faster than complex ones. A non-displaced fracture (a crack) may need less immobilization than a displaced or comminuted fracture (where bone fragments have shifted). Complex fractures, especially those involving joint surfaces, often require longer healing and sometimes surgery before casting.
Distal radius fractures, a common wrist break, typically require casting for four to eight weeks; stable ones might need around six. Scaphoid fractures, involving a small bone near the thumb’s base, often need six to twelve weeks or more due to their precarious blood supply, which can impede healing.
Patient age plays a role. Infants and young children heal fastest. As individuals age, slower metabolism and fewer stem cells extend healing. Older adults, especially with osteoporosis, may heal slower due to lower bone quality.
Overall health conditions, like diabetes, can slow healing. Smoking is detrimental, as nicotine and other chemicals delay or prevent healing. Good nutrition, with adequate protein, calcium, and vitamins D and K, supports healing.
Adherence to medical advice is important for healing. This includes:
Keeping the cast dry.
Avoiding weight-bearing activities on the wrist.
Attending all follow-up appointments.
Regular X-rays monitor healing progress, ensuring stability and protection.
The Bone Healing Process
The body repairs a broken bone in stages. The inflammatory stage begins, forming a blood clot (hematoma) at the injury site. This clot bridges bone pieces and signals cells, causing swelling and pain.
Within about a week, the reparative stage begins. The blood clot is replaced by a soft callus (soft bone). This callus holds fragments but isn’t strong enough for significant stress. Over subsequent weeks, it hardens as new bone tissue forms and minerals are deposited.
The remodeling stage starts around six weeks post-injury and can continue for months or years. During this phase, the body replaces the hard callus with normal bone, reshaping the fracture site. The cast plays an important role by immobilizing the bone, maintaining alignment, and providing a stable environment for healing.
Life After Cast Removal
Upon cast removal, individuals experience temporary changes in their wrist and hand. Stiffness and weakness are typical due to immobilization and muscle atrophy. Skin may be dry, flaky, or discolored, with normal swelling and discomfort. Gently wash and moisturize; pain relief can help manage discomfort to allow exercise.
Physical therapy is an important step in recovery to regain strength, flexibility, and range of motion. A therapist might use warm/cold treatments, electrical stimulation, and manipulation to alleviate pain and stiffness. They will guide patients through specific exercises (e.g., wrist circles, flexion, extension, grip strengthening) tailored to individual progress.
Home exercises are important for consistent progress and preventing stiffness. Gradually reintroduce normal activities, starting with light tasks (e.g., fastening buttons, washing, eating). Avoid heavy lifting or strenuous activities until cleared by your doctor to prevent re-injury. A soft wrist splint may be recommended for comfort or support.
While the bone may show healing after cast removal, full functional recovery, including strength and mobility, can take several months. The wrist may feel sensitive. A gradual return to more demanding activities ensures the best long-term outcome.
Signs of Delayed Healing
Recognize signs of delayed healing or complications. Persistent or worsening pain, especially if severe and uncontrolled by medication or elevation, warrants immediate medical attention. Increased swelling, numbness, or tingling in fingers or hand could suggest nerve compression or circulation issues, requiring prompt assessment. Bluish discoloration or coldness in fingers indicates compromised blood flow.
Signs of infection (fever, foul odor from cast, discharge/pus, redness/warmth around edges) require evaluation. Other indicators include inability to move fingers, a cast feeling suddenly too tight or loose, or cracks/soft spots. Persistent itching or burning under the cast should be reported. Promptly reporting these symptoms allows for timely intervention, crucial for optimizing healing and preventing complications.