While “broken wrist syndrome” is a common term, it refers to a wrist fracture: a break in one or more of the wrist’s bones. Wrist fractures are frequent injuries, often resulting from falls, and can significantly impact daily activities.
Understanding Wrist Fractures
The wrist is a complex joint composed of ten bones, including the two forearm bones and eight carpal bones. The larger forearm bone, located on the thumb side, is the radius, while the smaller forearm bone is the ulna. The eight carpal bones are arranged in two rows at the base of the hand. A fracture can occur in any of these bones, though the radius is most commonly affected.
Wrist fractures frequently happen when a person falls onto an outstretched hand, a mechanism often referred to as a “FOOSH” injury. The way a person lands and the force involved influence the type and severity of the fracture. Direct trauma to the wrist, such as during sports or motor vehicle crashes, can also cause these breaks.
One of the most common types is a Colles’ fracture, which involves a break in the distal radius, the part of the radius near the wrist. This fracture typically results from falling on an outstretched hand with the wrist bent backward, causing the broken end of the radius to tilt upward. Another type, a Smith fracture, is less common and involves the distal radius tilting downward, often from falling on a bent wrist. Less common fractures include scaphoid fractures, which involve a small bone near the base of the thumb, and ulnar styloid fractures, affecting the bony projection on the pinky side of the wrist.
Recognizing a Wrist Fracture
Recognizing a wrist fracture involves looking for several common signs. Severe pain, worsening with movement, gripping, or squeezing, is common. Swelling and tenderness around the injured area are also typical.
A noticeable deformity, such as a bent or crooked wrist, can suggest a fracture, though some breaks may not cause obvious deformity. Bruising and stiffness are often present. Nerve involvement can also lead to numbness or tingling in the fingers, requiring immediate medical attention.
Healthcare providers diagnose wrist fractures through physical examination, gently feeling and moving the wrist to assess the injury. Imaging confirms the diagnosis and determines fracture specifics. X-rays are usually the first step, effectively showing bone. For complex fractures or to identify soft tissue, nerve, or ligament injuries, a computed tomography (CT) scan or magnetic resonance imaging (MRI) may be used.
Treatment Approaches
Treatment for a wrist fracture depends on several factors, including the fracture’s type, severity, and stability, as well as the patient’s age and overall health. The goal is to realign and stabilize broken bone fragments for proper healing.
Non-surgical approaches are often effective for stable fractures with minimal displacement. These methods typically involve immobilization with a cast or splint, which keeps the bones in place while they heal. Pain management, often with over-the-counter medications, is also part of conservative treatment. A splint might be applied initially to decrease swelling, followed by a more rigid cast.
For complex or unstable fractures, surgery may be necessary. Open reduction and internal fixation (ORIF) is a common surgical procedure where an incision is made to realign and secure bone fragments with plates, screws, or pins. This method provides stable fixation and can allow for earlier wrist movement. In some cases, pins may be inserted without a large incision (percutaneous pinning) to stabilize the fracture, often with casting.
Recovery and Rehabilitation
Recovery for a wrist fracture varies depending on its severity and treatment method, ranging from weeks to months. After initial immobilization (cast or surgery), the wrist may feel stiff and weak.
Physical and occupational therapy play a significant role in restoring function. Physical therapists guide patients through exercises to improve wrist, hand, and forearm range of motion, flexibility, and strength. These exercises may include wrist circles, flexion, extension, and rotational movements, progressing to resistance exercises with weights or bands as healing advances.
Occupational therapists help individuals regain the ability to perform daily activities. They may use modalities like heat, ice, and electrical stimulation to manage pain and swelling. They also provide instruction on exercises to improve grip strength, coordination, and dexterity, helping patients return to usual tasks. Adherence to the prescribed rehabilitation program is important, as stiffness, prolonged pain, or arthritis can be challenges during recovery.